WorldWideScience

Sample records for higher cost bmps

  1. Cost-effectiveness and cost-benefit analysis of BMPs in controlling agricultural nonpoint source pollution in China based on the SWAT model.

    Science.gov (United States)

    Liu, Ruimin; Zhang, Peipei; Wang, Xiujuan; Wang, Jiawei; Yu, Wenwen; Shen, Zhenyao

    2014-12-01

    Best management practices (BMPs) have been widely used in managing agricultural nonpoint source pollution (ANSP) at the watershed level. Most BMPs are related to land use, tillage management, and fertilizer levels. In total, seven BMP scenarios (Reforest1, Reforest2, No Tillage, Contour tillage, and fertilizer level 1-4) that are related to these three factors were estimated in this study. The objectives were to investigate the effectiveness and cost-benefit of these BMPs on ANSP reduction in a large tributary of the Three Gorges Reservoir (TGR) in China, which are based on the simulation results of the Soil and Water Assessment Tool (SWAT) model. The results indicated that reforestation was the most economically efficient of all BMPs, and its net benefits were up to CNY 4.36×10(7) years(-1) (about USD 7.08×10(6) years(-1)). Regarding tillage practices, no tillage practice was more environmentally friendly than other tillage practices, and contour tillage was more economically efficient. Reducing the local fertilizer level to 0.8-fold less than that of 2010 can yield a satisfactory environmental and economic efficiency. Reforestation and fertilizer management were more effective in reducing total phosphorus (TP), whereas tillage management was more effective in reducing total nitrogen (TN). When CNY 10,000 (about USD 162) was applied to reforestation, no tillage, contour tillage, and an 0.8-fold reduction in the fertilizer level, then annual TN load can be reduced by 0.08, 0.16, 0.11, and 0.04 t and annual TP load can be reduced by 0.04, 0.02, 0.01 and 0.03 t, respectively. The cost-benefit (CB) ratios of the BMPs were as follows: reforestation (207 %) > contour tillage (129 %) > no tillage (114 %) > fertilizer management (96 and 89 %). The most economical and effective BMPs can be designated as follows: BMP1 (returning arable land with slopes greater than 25° to forests and those lands with slopes of 15-25° to orchards), BMP2 (implementing no tillage

  2. BMPs in urban stormwater management in Denmark and Sweden

    DEFF Research Database (Denmark)

    Mikkelsen, Peter Steen; Viklander, M.; Linde, Jens Jørgen

    2002-01-01

    Best Management Practices (BMPs) for control of stormwater runoff include structural elemts (structural BMPs) that can be applied on the local scale (e.g. infiltration), the drainage catchment scale (e.g. ponds and treatment, or wetlands) and the receiving water scale (e.g. retrofitting of river ....... A review of recent experiences with selected stormwater BMPs in Denmark and Sweden is presented and discussed with respect to the current issues related to legislation and the forces driving future development in stormwater management.......Best Management Practices (BMPs) for control of stormwater runoff include structural elemts (structural BMPs) that can be applied on the local scale (e.g. infiltration), the drainage catchment scale (e.g. ponds and treatment, or wetlands) and the receiving water scale (e.g. retrofitting of river...... reaches), and non-structural BMPs, such as controls of chemicals or building materials, and street sweeping. The available knowledge of stormwater BMPs performance in pollution control is inconsistent and the effect of various BMPs on receiving water quality is either poorly understood, or not known...

  3. Integrated agro-hydrological modelling and economic analysis of BMPs to support decision making and policy design

    Science.gov (United States)

    Maroy, E.; Rousseau, A. N.; Hallema, D. W.

    2012-12-01

    With recent efforts and increasing control over point source pollution of freshwater, agricultural non-point pollution sources have become responsible for most of sediment and nutrient loads in North American water systems. Environmental and agricultural agencies have recognised the need for reducing eutrophication and have developed various policies to compel or encourage producers to best management practices (BMPs). Addressing diffuse pollution is challenging considering the complex and cumulative nature of transport processes, high variability in space and time, and prohibitive costs of distributed water quality monitoring. Many policy options exist to push producers to adopt environmentally desirable behaviour while keeping their activity viable, and ensure equitable costs to consumers and tax payers. On the one hand, economic instruments (subsidies, taxes, water quality markets) are designed to maximize cost-effectiveness, so that farmers optimize their production for maximum profit while implementing BMPs. On the other hand, emission standards or regulation of inputs are often easier and less costly to implement. To study economic and environmental impacts of such policies, a distributed modelling approach is needed to deal with the complexity of the system and the large environmental and socio-economic data requirements. Our objective is to integrate agro-hydrological modelling and economic analysis to support decision and policy making processes of BMP implementation. The integrated modelling system GIBSI was developed in an earlier study within the Canadian WEBs project (Watershed Evaluation of BMPs) to evaluate the influence of BMPs on water quality. The case study involved 30 and 15 year records of discharge and water quality measurements respectively, in the Beaurivage River watershed (Quebec, Canada). GIBSI provided a risk-based overview of the impact of BMPs (including vegetated riparian buffer strips, precision slurry application, conversion to

  4. 40 CFR 430.28 - Best management practices (BMPs).

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Best management practices (BMPs). 430.28 Section 430.28 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT... Soda Subcategory § 430.28 Best management practices (BMPs). The definitions and requirements set forth...

  5. 40 CFR 430.58 - Best management practices (BMPs).

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Best management practices (BMPs). 430.58 Section 430.58 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT... § 430.58 Best management practices (BMPs). The definitions and requirements set forth in 40 CFR 430.03...

  6. Effect of BMPs on hematopoietic injury of acute radiation sickness in mice

    International Nuclear Information System (INIS)

    Tian Qiong; Zhang Shaozhang; Pu Qin; Zhang Fake; Hannah, X.H.

    2000-01-01

    The purpose of this paper is to investigate the effect of Bone morphogenetic proteins (BMPs) on hematopoietic acute radiation sickness in mice. BMP, rhBMP-2m and PBK/hBMP-2-NIH3T3 cells were obtained separately by chemistry, molecule biological method and genetherapy method. In this study, the effect of BMPs on hematopoiesis was detected at postirradiation: some hematological parameters, 30 days the survival ratio and formation of bone marrow CFU-GM colony. The experiments indicate that when phBMP (purified bovine bone morphogenetic protein) can increase the formation of bone narrow CFU-GM colony (p<0.05) at 10th d after irradiation. Irradiation control group's mice died in 30 days, but effect of rhBMP-2m on the survival of mice after 7.5Gy irradiation, was detected whereas there were 10%, 15% and 35% all mice of survived after injection i.p. with 0.5 mg, 1.0 mg and 2.0 mg of rhBMP-2m respectively. All hematological parameters of treated mice were significantly higher than control group (p<0.01). PBK/hBMP-2-NIH3T3 cells were established and transplanted into mice irradiated by 7.0Gy r ray by i.p., the survival ratio of treated mice higher than negative control group (p<0.01), and all hematopoietic parameters were increased statistically significant (p<0.01). These data support the our hypothesis: BMPs can treat the acute radiation sickness. The results indicate that in adult mice, BMPs can recover or treat the hematopoietic injury of acute radiation sickness in mice. (author)

  7. Forestry BMP Implementation Costs for Virginia

    Science.gov (United States)

    R.M. Shaffer; H.L. Haney; E.G. Worrell; W.M. Aust

    1998-01-01

    Forestry Best Management Practices (BMPs) are operational techniques used to protect water quality during timber harvesting operations. The implementation cost of BMPs is important to loggers, forest landowners, and the forest industry. This study provides an estimate of BMP implementation cost on a per harvested acre basis for the coastal plain, Piedmont, and...

  8. Histomorphometric analysis of rat alveolar wound healing with hydroxyapatite alone or associated to BMPs

    Directory of Open Access Journals (Sweden)

    Brandão Alexandre C.

    2002-01-01

    Full Text Available Several materials and techniques have been proposed to improve alveolar wound healing and decrease loss of bone height and thickness that normally follow dental extraction. The objective of this research was the histologic analysis of bone morphogenetic proteins implanted into dental alveoli of rats after extraction. A total of 45 adult male Wistar rats were divided into three groups of 15 animals each: control (no treatment, implanted with pure hydroxyapatite (HA, 3 mg and implanted with hydroxyapatite plus bone morphogenetic proteins (HA/BMPs, 3 mg. Five animals from each group were sacrificed at 7, 21 and 42 days after extraction for the histometric analyses of the osteoconductive potential of hydroxyapatite associated or not with BMPs. After dissection, fixation, decalcification and serial microtomy of 6-mm thick sections, the samples were stained with hematoxylin-eosin for histologic and histometric analyses. Both HA and HA/BMPs caused a delay in wound healing compared to control animals, evaluated by the percentage of bone tissue in the alveoli. The treatment with HA/BMPs had the greatest delay at 21 days, even though it produced values similar to the control group at 42 days. The materials did not improve alveolar repair in the normal period of wound healing and the association of HA/BMPs did not have osteoconductive properties with granulated hydroxyapatite as the vehicle.

  9. Enhancing a rainfall-runoff model to assess the impacts of BMPs and LID practices on storm runoff.

    Science.gov (United States)

    Liu, Yaoze; Ahiablame, Laurent M; Bralts, Vincent F; Engel, Bernard A

    2015-01-01

    Best management practices (BMPs) and low impact development (LID) practices are increasingly being used as stormwater management techniques to reduce the impacts of urban development on hydrology and water quality. To assist planners and decision-makers at various stages of development projects (planning, implementation, and evaluation), user-friendly tools are needed to assess the effectiveness of BMPs and LID practices. This study describes a simple tool, the Long-Term Hydrologic Impact Assessment-LID (L-THIA-LID), which is enhanced with additional BMPs and LID practices, improved approaches to estimate hydrology and water quality, and representation of practices in series (meaning combined implementation). The tool was used to evaluate the performance of BMPs and LID practices individually and in series with 30 years of daily rainfall data in four types of idealized land use units and watersheds (low density residential, high density residential, industrial, and commercial). Simulation results were compared with the results of other published studies. The simulated results showed that reductions in runoff volume and pollutant loads after implementing BMPs and LID practices, both individually and in series, were comparable with the observed impacts of these practices. The L-THIA-LID 2.0 model is capable of assisting decision makers in evaluating environmental impacts of BMPs and LID practices, thereby improving the effectiveness of stormwater management decisions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Combining Water Quality and Cost-Benefit Analysis to Examine the Implications of Agricultural Best Management Practices

    Science.gov (United States)

    Rao, N. S.; Easton, Z. M.; Lee, D. R.; Steenhuis, T. S.

    2007-12-01

    Nutrient runoff from agricultural fields threatens water quality and can impair habitats in many watersheds. Agencies consider these potential risks as they determine acceptable levels of nutrient loading. For example, in the New York City (NYC) watershed, the Environmental Protection Agency's Total Maximum Daily Load (TMDL) for phosphorus (P) has been set at 15μg P L-1 to protect against eutrophication and bacterial outbreaks. In the NYC watersheds agricultural Best Management Practices (BMPs) are the primary means to control nonpoint source P loading. BMPs include riparian buffers, filter strips, manure storage facilities, crop rotation, stripcropping, tree planting and nutrient management plans (NMPs). Water quality research on BMPs to date has included studies on site-specificity of different BMPs, short and long term BMP efficacy, and placement of BMPs with respect to critical source areas. A necessary complement to studies addressing water quality aspects of different BMPs are studies examining the cost-benefit aspects of BMPs. In general, there are installment, maintenance and opportunity costs associated with each BMP, and there are benefits, including cost share agreements between farmers and farm agencies, and increased efficiency of farm production and maintenance. Combining water quality studies and related cost-benefit analyses would help planners and watershed managers determine how best improve water quality. Our research examines the costs-benefit structure associated with BMP scenarios on a one-farm headwater watershed in the Catskill Mountains of NY. The different scenarios include "with and without" BMPs, combinations of BMPs, and different BMP placements across agricultural fields. The costs associated with each BMP scenarios are determined using information from farm agencies and watershed planning agencies. With these data we perform a cost-benefit analysis for the different BMP scenarios and couple the water quality modeling using the

  11. Reducing surface water pollution through the assessment of the cost-effectiveness of BMPs at different spatial scales.

    Science.gov (United States)

    Panagopoulos, Y; Makropoulos, C; Mimikou, M

    2011-10-01

    Two kinds of agricultural Best Management Practices (BMPs) were examined with respect to cost-effectiveness (CE) in reducing sediment, nitrates-nitrogen (NO(3)-N) and total phosphorus (TP) losses to surface waters of the Arachtos catchment in Western Greece. The establishment of filter strips at the edge of fields and a non-structural measure, namely fertilization reduction in alfalfa, combined with contour farming and zero-tillage in corn and reduction of animal numbers in pastureland, were evaluated. The Soil and Water Assessment Tool (SWAT) model was used as the non-point-source (NPS) estimator, while a simple economic component was developed estimating BMP implementation cost as the mean annual expenses needed to undertake and operate the practice for a 5-year period. After each BMP implementation, the ratio of their CE in reducing pollution was calculated for each Hydrologic Response Unit (HRU) separately, for each agricultural land use type entirely and for the whole catchment. The results at the HRU scale are presented comprehensively on a map, demonstrating the spatial differentiation of CE ratios across the catchment that enhances the identification of locations where each BMP is most advisable for implementation. Based on the analysis, a catchment management solution of affordable total cost would include the expensive measure of filter strips in corn and only in a small number of pastureland fields, in combination with the profitable measure of reducing fertilization to alfalfa fields. When examined for its impact on river loads at the outlet, the latter measure led to a 20 tn or 8% annual decrease of TP from the baseline with savings of 15€/kg of pollutant reduction. Filter strips in corn fields reduced annual sediments by 66 Ktn or 5%, NO(3)-N by 71 tn or 9.5% and TP by 27 tn or 10%, with an additional cost of 3.1 €/tn, 3.3 €/kg and 8.1 €/kg of each pollutant respectively. The study concludes that considerable reductions of several

  12. 40 CFR 412.4 - Best management practices (BMPs) for land application of manure, litter, and process wastewater.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Best management practices (BMPs) for... FEEDING OPERATIONS (CAFO) POINT SOURCE CATEGORY § 412.4 Best management practices (BMPs) for land... implement best management practices. Each CAFO subject to this section that land applies manure, litter, or...

  13. Hydrological simulation approaches for BMPs and LID practices in highly urbanized area and development of hydrological performance indicator system

    Directory of Open Access Journals (Sweden)

    Yan-wei Sun

    2014-04-01

    Full Text Available Urbanization causes hydrological change and increases stormwater runoff volumes, leading to flooding, erosion, and the degradation of instream ecosystem health. Best management practices (BMPs, like detention ponds and infiltration trenches, have been widely used to control flood runoff events for the past decade. However, low impact development (LID options have been proposed as an alternative approach to better mimic the natural flow regime by using decentralized designs to control stormwater runoff at the source, rather than at a centralized location in the watershed. For highly urbanized areas, LID stormwater management practices such as bioretention cells and porous pavements can be used to retrofit existing infrastructure and reduce runoff volumes and peak flows. This paper describes a modeling approach to incorporate these LID practices and the two BMPs of detention ponds and infiltration trenches in an existing hydrological model to estimate the impacts of BMPs and LID practices on the surface runoff. The modeling approach has been used in a parking lot located in Lenexa, Kansas, USA, to predict hydrological performance of BMPs and LID practices. A performance indicator system including the flow duration curve, peak flow frequency exceedance curve, and runoff coefficient have been developed in an attempt to represent impacts of BMPs and LID practices on the entire spectrum of the runoff regime. Results demonstrate that use of these BMPs and LID practices leads to significant stormwater control for small rainfall events and less control for flood events.

  14. Implementation of retrofit BMPs in a suburban watershed via economic incentives

    Science.gov (United States)

    Urban stormwater is typically conveyed to centralized infrastructure, and there is great potential for reducing stormwater runoff quantity through decentralization. In this case we hypothesize that smaller-scale retrofit best management practices (BMPs) such as rain gardens and r...

  15. Alveolar wound healing after implantation with a pool of commercially available bovine bone morphogenetic proteins (BMPs): a histometric study in rats.

    Science.gov (United States)

    Calixto, Romeu Felipe Elias; Teófilo, Juliana Mazzonetto; Brentegani, Luiz Guilherme; Lamano-Carvalho, Teresa Lúcia

    2007-01-01

    The capacity of a commercially available pool of bovine bone morphogenetic proteins (BMPs) to stimulate osteogenesis in the rat alveolar healing was investigated by histometric analysis. Male rats were anesthetized and had their upper incisor extracted. A pool of purified bovine BMPs adsorbed to microgranular resorbable hydroxyapatite was agglutinated with bovine collagen and saline before implantation into the alveolar socket. The implanted and control rats (n=30 per group) were sacrificed 1 to 9 weeks postoperatively, the hemi-maxillae were decalcified, processed for paraffin embedding and semi-serial longitudinal sections were obtained and stained with hematoxylin and eosin. The volume fraction of alveolar healing components was estimated by a differential point-counting method in histologic images. The results showed that in both, control and implanted rats, the alveolar healing followed the histologic pattern usually described in the literature. Quantitative data confirmed that the BMPs mixture did not stimulate new bone formation in the alveolar socket of implanted rats. These results suggest that the pool of BMPs adsorbed to hydroxyapatite and agglutinated with bovine collagen did not warrant incorporation of the osteoinductive proteins to a slow-absorption system that would allow a BMPs release rate compatible to that of new bone formation, and thus more adequate to osteoinduction.

  16. Effective post-construction best management practices (BMPs) to infiltrate and retain stormwater runoff.

    Science.gov (United States)

    2017-06-01

    Performance analyses of newly constructed linear BMPs in retaining stormwater run-off from 1 in. precipitation in : post-construction highway applications and urban areas were conducted using numerical simulations and field : observation. A series of...

  17. Development and evaluation of best management practices (BMPS) for highway runoff pollution control.

    Science.gov (United States)

    2013-12-01

    Polluted storm water runoff is commonly transported through Municipal Separate Storm Sewer Systems (MS4s). Currently, : sufficient information is not available on development and evaluation of Best Management Practices (BMPs) within an MS4 : boundary...

  18. BMPs regulate msx gene expression in the dorsal neuroectoderm of Drosophila and vertebrates by distinct mechanisms.

    Science.gov (United States)

    Esteves, Francisco F; Springhorn, Alexander; Kague, Erika; Taylor, Erika; Pyrowolakis, George; Fisher, Shannon; Bier, Ethan

    2014-09-01

    In a broad variety of bilaterian species the trunk central nervous system (CNS) derives from three primary rows of neuroblasts. The fates of these neural progenitor cells are determined in part by three conserved transcription factors: vnd/nkx2.2, ind/gsh and msh/msx in Drosophila melanogaster/vertebrates, which are expressed in corresponding non-overlapping patterns along the dorsal-ventral axis. While this conserved suite of "neural identity" gene expression strongly suggests a common ancestral origin for the patterning systems, it is unclear whether the original regulatory mechanisms establishing these patterns have been similarly conserved during evolution. In Drosophila, genetic evidence suggests that Bone Morphogenetic Proteins (BMPs) act in a dosage-dependent fashion to repress expression of neural identity genes. BMPs also play a dose-dependent role in patterning the dorsal and lateral regions of the vertebrate CNS, however, the mechanism by which they achieve such patterning has not yet been clearly established. In this report, we examine the mechanisms by which BMPs act on cis-regulatory modules (CRMs) that control localized expression of the Drosophila msh and zebrafish (Danio rerio) msxB in the dorsal central nervous system (CNS). Our analysis suggests that BMPs act differently in these organisms to regulate similar patterns of gene expression in the neuroectoderm: repressing msh expression in Drosophila, while activating msxB expression in the zebrafish. These findings suggest that the mechanisms by which the BMP gradient patterns the dorsal neuroectoderm have reversed since the divergence of these two ancient lineages.

  19. BMPs regulate msx gene expression in the dorsal neuroectoderm of Drosophila and vertebrates by distinct mechanisms.

    Directory of Open Access Journals (Sweden)

    Francisco F Esteves

    2014-09-01

    Full Text Available In a broad variety of bilaterian species the trunk central nervous system (CNS derives from three primary rows of neuroblasts. The fates of these neural progenitor cells are determined in part by three conserved transcription factors: vnd/nkx2.2, ind/gsh and msh/msx in Drosophila melanogaster/vertebrates, which are expressed in corresponding non-overlapping patterns along the dorsal-ventral axis. While this conserved suite of "neural identity" gene expression strongly suggests a common ancestral origin for the patterning systems, it is unclear whether the original regulatory mechanisms establishing these patterns have been similarly conserved during evolution. In Drosophila, genetic evidence suggests that Bone Morphogenetic Proteins (BMPs act in a dosage-dependent fashion to repress expression of neural identity genes. BMPs also play a dose-dependent role in patterning the dorsal and lateral regions of the vertebrate CNS, however, the mechanism by which they achieve such patterning has not yet been clearly established. In this report, we examine the mechanisms by which BMPs act on cis-regulatory modules (CRMs that control localized expression of the Drosophila msh and zebrafish (Danio rerio msxB in the dorsal central nervous system (CNS. Our analysis suggests that BMPs act differently in these organisms to regulate similar patterns of gene expression in the neuroectoderm: repressing msh expression in Drosophila, while activating msxB expression in the zebrafish. These findings suggest that the mechanisms by which the BMP gradient patterns the dorsal neuroectoderm have reversed since the divergence of these two ancient lineages.

  20. Cost Efficiency in Public Higher Education.

    Science.gov (United States)

    Robst, John

    This study used the frontier cost function framework to examine cost efficiency in public higher education. The frontier cost function estimates the minimum predicted cost for producing a given amount of output. Data from the annual Almanac issues of the "Chronicle of Higher Education" were used to calculate state level enrollments at two-year and…

  1. Spatially-Distributed Cost-Effectiveness Analysis Framework to Control Phosphorus from Agricultural Diffuse Pollution.

    Directory of Open Access Journals (Sweden)

    Runzhe Geng

    Full Text Available Best management practices (BMPs for agricultural diffuse pollution control are implemented at the field or small-watershed scale. However, the benefits of BMP implementation on receiving water quality at multiple spatial is an ongoing challenge. In this paper, we introduce an integrated approach that combines risk assessment (i.e., Phosphorus (P index, model simulation techniques (Hydrological Simulation Program-FORTRAN, and a BMP placement tool at various scales to identify the optimal location for implementing multiple BMPs and estimate BMP effectiveness after implementation. A statistically significant decrease in nutrient discharge from watersheds is proposed to evaluate the effectiveness of BMPs, strategically targeted within watersheds. Specifically, we estimate two types of cost-effectiveness curves (total pollution reduction and proportion of watersheds improved for four allocation approaches. Selection of a ''best approach" depends on the relative importance of the two types of effectiveness, which involves a value judgment based on the random/aggregated degree of BMP distribution among and within sub-watersheds. A statistical optimization framework is developed and evaluated in Chaohe River Watershed located in the northern mountain area of Beijing. Results show that BMP implementation significantly (p >0.001 decrease P loss from the watershed. Remedial strategies where BMPs were targeted to areas of high risk of P loss, deceased P loads compared with strategies where BMPs were randomly located across watersheds. Sensitivity analysis indicated that aggregated BMP placement in particular watershed is the most cost-effective scenario to decrease P loss. The optimization approach outlined in this paper is a spatially hierarchical method for targeting nonpoint source controls across a range of scales from field to farm, to watersheds, to regions. Further, model estimates showed targeting at multiple scales is necessary to optimize program

  2. Cost and Price Increases in Higher Education: Evidence of a Cost Disease on Higher Education Costs and Tuition Prices and the Implications for Higher Education Policy

    Science.gov (United States)

    Trombella, Jerry

    2011-01-01

    As concern over rapidly rising college costs and tuition sticker prices have increased, a variety of research has been conducted to determine potential causes. Most of this research has focused on factors unique to higher education. In contrast, cost disease theory attempts to create a comparative context to explain cost increases in higher…

  3. Activity-Based Costing Systems for Higher Education.

    Science.gov (United States)

    Day, Dennis H.

    1993-01-01

    Examines traditional costing models utilized in higher education and pinpoints shortcomings related to proper identification of costs. Describes activity-based costing systems as a superior alternative for cost identification, measurement, and allocation. (MLF)

  4. Water quality impact assessment of agricultural Beneficial Management Practices (BMPs) simulated for a regional catchment in Quebec, Eastern Canada

    Science.gov (United States)

    Rousseau, Alain N.; Hallema, Dennis W.; Gumiere, Silvio J.; Savary, Stéphane; Hould Gosselin, Gabriel

    2014-05-01

    Water quality has become a matter of increasing concern over the past four decades as a result of the intensification of agriculture, and more particularly so in Canada where agriculture has evolved into the largest non-point source of surface water pollution. The Canadian WEBs project (Watershed Evaluation of Beneficial Management Practices, BMPs) was initiated in order to determine the efficiency of BMPs in improving the surface water quality of rural catchments, and the economic aspects related to their implementation on the same scale. In this contribution we use the integrated watershed modelling platform GIBSI (Gestion Intégrée des Bassins versants à l'aide d'un Système Informatisé) to evaluate the effects of various BMPs on sediment and nutrient yields and, in close relation to this, the surface water quality for the Beaurivage River catchment (718 km2) in Quebec, eastern Canada. A base scenario of the catchment is developed by calibrating the different models of the GIBSI platform, namely HYDROTEL for hydrology, the Revised Universal Soil Loss Equation (RUSLE) for soil erosion, the Erosion-Productivity Impact Calculator (EPIC) of the Soil and Water Assessment Tool (SWAT) for contaminant transport and fate, and QUAL2E for stream water quality. Four BMPs were analysed: (1) vegetated riparian buffer strips, (2) precision slurry application, (3) transition of all cereal and corn fields to grassland (grassland conversion), and (4) no-tillage on corn fields. Simulations suggest that riparian buffer strips and grassland conversion are more effective in terms of phosphorus, nitrogen and sediment load reduction than precision slurry application and no-tillage on corn fields. The results furthermore indicate the need for a more profound understanding of sediment dynamics in streams and on riparian buffer strips.

  5. Assessment of the Effectiveness of Green Infrastructure Stormwater Best Management Practices (BMPs) at the Small Watershed Scale

    Science.gov (United States)

    There have been numerous studies of the water quantity and quality functions of stormwater BMPs at the site scale, but relatively few assessments at the watershed scale. This presentation will present an overview and initial results of projects to evaluate the effectiveness of g...

  6. Analysis of the efficacy and cost-effectiveness of best management practices for controlling sediment yield: A case study of the Joumine watershed, Tunisia.

    Science.gov (United States)

    Mtibaa, Slim; Hotta, Norifumi; Irie, Mitsuteru

    2018-03-01

    Soil erosion can be reduced through the strategic selection and placement of best management practices (BMPs) in critical source areas (CSAs). In the present study, the Soil Water Assessment Tool (SWAT) model was used to identify CSAs and investigate the effectiveness of different BMPs in reducing sediment yield in the Joumine watershed, an agricultural river catchment located in northern Tunisia. A cost-benefit analysis (CBA) was used to evaluate the cost-effectiveness of different BMP scenarios. The objective of the present study was to determine the most cost-effective management scenario for controlling sediment yield. The model performance for the simulation of streamflow and sediment yield at the outlet of the Joumine watershed was good and satisfactory, respectively. The model indicated that most of the sediment was originated from the cultivated upland area. About 34% of the catchment area consisted of CSAs that were affected by high to very high soil erosion risk (sediment yield >10t/ha/year). Contour ridges were found to be the most effective individual BMP in terms of sediment yield reduction. At the watershed level, implementing contour ridges in the CSAs reduced sediment yield by 59%. Combinations of BMP scenarios were more cost-effective than the contour ridges alone. Combining buffer strips (5-m width) with other BMPs depending on land slope (> 20% slope: conversion to olive orchards; 10-20% slope: contour ridges; 5-10% slope: grass strip cropping) was the most effective approach in terms of sediment yield reduction and economic benefits. This approach reduced sediment yield by 61.84% with a benefit/cost ratio of 1.61. Compared with the cost of dredging, BMPs were more cost-effective for reducing sediment loads to the Joumine reservoir, located downstream of the catchment. Our findings may contribute to ensure the sustainability of future conservation programs in Tunisian regions. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Platelet-rich plasma stimulates osteoblastic differentiation in the presence of BMPs

    International Nuclear Information System (INIS)

    Tomoyasu, Akihiro; Higashio, Kanji; Kanomata, Kazuhiro; Goto, Masaaki; Kodaira, Kunihiko; Serizawa, Hiroko; Suda, Tatsuo; Nakamura, Atsushi; Nojima, Junya; Fukuda, Toru; Katagiri, Takenobu

    2007-01-01

    Platelet-rich plasma (PRP) is clinically used as an autologous blood product to stimulate bone formation in vivo. In the present study, we examined the effects of PRP on proliferation and osteoblast differentiation in vitro in the presence of bone morphogenetic proteins (BMPs). PRP and its soluble fraction stimulated osteoblastic differentiation of myoblasts and osteoblastic cells in the presence of BMP-2, BMP-4, BMP-6 or BMP-7. The soluble PRP fraction stimulated osteoblastic differentiation in 3D cultures using scaffolds made of collagen or hydroxyapatite. Moreover, heparin-binding fractions obtained from serum also stimulated osteoblastic differentiation in the presence of BMP-4. These results suggested that platelets contain not only growth factors for proliferation but also novel potentiator(s) for BMP-dependent osteoblastic differentiation

  8. Conjoint Analysis of Farmers’ Response to Conservation Incentives

    Directory of Open Access Journals (Sweden)

    David Conner

    2016-07-01

    Full Text Available Environmental degradation threatens the long term resiliency of the US food and farming system. While USDA has provided conservation incentives for the adoption of best management practices (BMPs, only a small percentage of farms have participated in such conservation programs. This study uses conjoint analysis to examine Vermont farmers’ underlying preferences and willingness-to-accept (WTA incentives for three common BMPs. Based on the results of this survey, we hypothesize that federal cost share programs’ payments are below preferred incentive levels and that less familiar and more complex BMPs require a higher payment. Our implications focus on strategies to test these hypotheses and align incentive payments and other non-monetary options to increase BMP adoption.

  9. Evaluating the Least Cost Selection of Agricultural Management Practices in the Five Mile Creek area of Fort Cobb Watershed, Oklahoma, USA

    Science.gov (United States)

    Rasoulzadeh Gharibdousti, S.; Stoecker, A.; Storm, D.

    2017-12-01

    One of the main causes of water quality impairment in the United States is human induced Non-Point Source (NPS) pollution through intensive agriculture. The Fort Cobb Reservoir (FCR) watershed located in west-central Oklahoma, United States is a rural agricultural catchment with known issues of NPS pollution including suspended solids, siltation, nutrients, and pesticides. Recently, several Best Management Practices (BMPs) have been implemented in the watershed (such as no-tillage and cropland to grassland conversion) to improve water quality. The objective in this study is to estimate the most cost effective selection and placement of BMPs on farmlands to mitigate soil erosion and the delivery of sediment and nutrient loads to the FCR from Five Mile Creek (FMC) area of the FCR watershed. We employed the Soil and Water Assessment Tool (SWAT) to develop the hydrological model of the study area. The watershed was delineated using the 10 m National Elevation Dataset and divided into 43 sub-basins with an average area of 8 km2. Through a combination of Soil Survey Geographic Database- SSURGO soil data, the US Department of Agriculture crop layer and the slope information, the watershed was further divided into 15,217 hydrologic response units (HRUs). The historical climate pattern in the watershed was represented by two different weather stations. The model was calibrated for the 1991 - 2000 period and validated over the 2001 - 2010 period against the monthly USGS observations of streamflow and suspended sediment concentration recorded at the watershed outlet. Model parametrization resulted in satisfactory values for the R2 (0.64, 0.35) and NS (0.61, 0.34) in calibration period and an excellent model performance (R2 = 0.79, 0.38; NS = 0.75, 0.43) in validation period for streamflow and sediment concentration respectively. We have selected 20 BMPs to estimate their efficacy in terms of water, sediment, and crop yields. Linear Programming (LP) was used to determine the

  10. Is higher nursing home quality more costly?

    Science.gov (United States)

    Giorgio, L Di; Filippini, M; Masiero, G

    2016-11-01

    Widespread issues regarding quality in nursing homes call for an improved understanding of the relationship with costs. This relationship may differ in European countries, where care is mainly delivered by nonprofit providers. In accordance with the economic theory of production, we estimate a total cost function for nursing home services using data from 45 nursing homes in Switzerland between 2006 and 2010. Quality is measured by means of clinical indicators regarding process and outcome derived from the minimum data set. We consider both composite and single quality indicators. Contrary to most previous studies, we use panel data and control for omitted variables bias. This allows us to capture features specific to nursing homes that may explain differences in structural quality or cost levels. Additional analysis is provided to address simultaneity bias using an instrumental variable approach. We find evidence that poor levels of quality regarding outcome, as measured by the prevalence of severe pain and weight loss, lead to higher costs. This may have important implications for the design of payment schemes for nursing homes.

  11. Collaborating to Cut Costs in Higher Education

    Science.gov (United States)

    Hassett, Tracy

    2017-01-01

    Tuition prices at colleges and universities are high. It is also true that salaries and benefits are the single biggest chunk of every higher education institution's (HEI) budget. And one of the largest and most difficult costs to contain is group employee health insurance. The situation is particularly difficult for smaller New England HEIs…

  12. Acute costs and predictors of higher treatment costs of trauma in New South Wales, Australia.

    Science.gov (United States)

    Curtis, Kate; Lam, Mary; Mitchell, Rebecca; Black, Deborah; Taylor, Colman; Dickson, Cara; Jan, Stephen; Palmer, Cameron S; Langcake, Mary; Myburgh, John

    2014-01-01

    Accurate economic data are fundamental for improving current funding models and ultimately in promoting the efficient delivery of services. The financial burden of a high trauma casemix to designated trauma centres in Australia has not been previously determined, and there is some evidence that the episode funding model used in Australia results in the underfunding of trauma. To describe the costs of acute trauma admissions in trauma centres, identify predictors of higher treatment costs and cost variance in New South Wales (NSW), Australia. Data linkage of admitted trauma patient and financial data provided by 12 Level 1 NSW trauma centres for the 08/09 financial year was performed. Demographic, injury details and injury scores were obtained from trauma registries. Individual patient general ledger costs (actual trauma patient costs), Australian Refined Diagnostic Related Groups (AR-DRG) and state-wide average costs (which form the basis of funding) were obtained. The actual costs incurred by the hospital were then compared with the state-wide AR-DRG average costs. Multivariable multiple linear regression was used for identifying predictors of costs. There were 17,522 patients, the average per patient cost was $10,603 and the median was $4628 (interquartile range: $2179-10,148). The actual costs incurred by trauma centres were on average $134 per bed day above AR-DRG costs-determined costs. Falls, road trauma and violence were the highest causes of total cost. Motor cyclists and pedestrians had higher median costs than motor vehicle occupants. As a result of greater numbers, patients with minor injury had comparable total costs with those generated by patients with severe injury. However the median cost of severely injured patients was nearly four times greater. The count of body regions injured, sex, length of stay, serious traumatic brain injury and admission to the Intensive Care Unit were significantly associated with increased costs (p<0.001). This

  13. The effects of BIG-3 on osteoblast differentiation are not dependent upon endogenously produced BMPs

    International Nuclear Information System (INIS)

    Gori, Francesca; Demay, Marie B.

    2005-01-01

    BMPs play an important role in both intramembranous and endochondral ossification. BIG-3, BMP-2-induced gene 3 kb, encodes a WD-40 repeat protein that accelerates the program of osteoblastic differentiation in vitro. To examine the potential interactions between BIG-3 and the BMP-2 pathway during osteoblastic differentiation, MC3T3-E1 cells stably transfected with BIG-3 (MC3T3E1-BIG-3), or with the empty vector (MC3T3E1-EV), were treated with noggin. Noggin treatment of pooled MC3T3E1-EV clones inhibited the differentiation-dependent increase in AP activity observed in the untreated MC3T3E1-EV clones but did not affect the increase in AP activity in the MC3T3E1-BIG-3 clones. Noggin treatment decreased the expression of Runx2 and type I collagen mRNAs and impaired mineralized matrix formation in MC3T3E1-EV clones but not in MC3T3E1-BIG-3 clones. To determine whether the actions of BIG-3 on osteoblast differentiation converged upon the BMP pathway or involved an alternate signaling pathway, Smad1 phosphorylation was examined. Basal phosphorylation of Smad1 was not altered in the MC3T3E1-BIG-3 clones. However, these clones did not exhibit the noggin-dependent decrease in phosphoSmad1 observed in the MC3T3E1-EV clones, nor did it decrease nuclear localization of phosphoSmad1. These observations suggest that BIG-3 accelerates osteoblast differentiation in MC3T3-E1 cells by inducing phosphorylation and nuclear translocation of Smad1 independently of endogenously produced BMPs

  14. Assessment of stormwater runoff management practices and BMPs under soil sealing: A study case in a peri-urban watershed of the metropolitan area of Rome (Italy).

    Science.gov (United States)

    Recanatesi, Fabio; Petroselli, Andrea; Ripa, Maria Nicolina; Leone, Antonio

    2017-10-01

    By 2006, almost 100,000 km 2 of EU soil (2.3% of the whole territory) had been sealed, with a per capita quota of 200 m 2 of sealed surface for each EU citizen. Italy, in 2016, recorded a soil sealing rate of 2.8% of the entire territory. In this context, the urban expansion which occurred in past decades is considered one of the main causes of the increase in flood frequency and intensity in small catchments, causing both social and financial damage. In the present paper, the positive impact of introducing Best Management Practices (BMPs) at urban scale is assessed, with particular regard to the decreasing of flood prone areas. A suburban watershed of the metropolitan area of Rome has been selected for a study case, as its soil sealing rate can be considered paradigmatic at this scale. Starting from the analysis of rainfall events occurring between 2008 and 2011 which caused millions of euros worth of damage, and using a high resolution data set in a GIS environment, two scenarios, with and without BMP introduction, are evaluated applying a rainfall-runoff model and a bidimensional hydraulic model. From a comparison of the flood maps with and without the introduction of BMPs, it was determined that in 90% of the circumstances the employment of the BMPs would completely remove the hydraulic risk, while in the remaining 10% the BMP would at least reduce the areas subjected to flooding. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Costing Principles in Higher Education and Their Application (First Revision).

    Science.gov (United States)

    Sterns, A. A.

    This document provides a reason for applying known cost-accounting methodology within the realm of higher education and attempts to make the known techniques viable for sets of objectives within the university environment. The plan developed here is applied to a department, the lowest level in the university hierarchy, and demonstrates costs in…

  16. Selection and placement of best management practices used to reduce water quality degradation in Lincoln Lake watershed

    Science.gov (United States)

    Rodriguez, Hector German; Popp, Jennie; Maringanti, Chetan; Chaubey, Indrajeet

    2011-01-01

    An increased loss of agricultural nutrients is a growing concern for water quality in Arkansas. Several studies have shown that best management practices (BMPs) are effective in controlling water pollution. However, those affected with water quality issues need water management plans that take into consideration BMPs selection, placement, and affordability. This study used a nondominated sorting genetic algorithm (NSGA-II). This multiobjective algorithm selects and locates BMPs that minimize nutrients pollution cost-effectively by providing trade-off curves (optimal fronts) between pollutant reduction and total net cost increase. The usefulness of this optimization framework was evaluated in the Lincoln Lake watershed. The final NSGA-II optimization model generated a number of near-optimal solutions by selecting from 35 BMPs (combinations of pasture management, buffer zones, and poultry litter application practices). Selection and placement of BMPs were analyzed under various cost solutions. The NSGA-II provides multiple solutions that could fit the water management plan for the watershed. For instance, by implementing all the BMP combinations recommended in the lowest-cost solution, total phosphorous (TP) could be reduced by at least 76% while increasing cost by less than 2% in the entire watershed. This value represents an increase in cost of 5.49 ha-1 when compared to the baseline. Implementing all the BMP combinations proposed with the medium- and the highest-cost solutions could decrease TP drastically but will increase cost by 24,282 (7%) and $82,306 (25%), respectively.

  17. Price Endogeneity and Marginal Cost Effects on Incentive Compatible Stormwater Management Policies

    OpenAIRE

    Huber, Matthew C.; Willis, David B.; Hayes, John C.; Privette, Charles V., III

    2010-01-01

    Incentive based stormwater management policies offer the prospect of reducing urban stormwater runoff while increasing developer profits. An incentive compatible Stormwater Banking Program (SBP) is presented that allows developers to build at higher residential densities in exchange for including low impact stormwater Best Management Practices (BMPs) in the development’s stormwater management infrastructure. Price endogeneity presents itself when the smaller residential lots created by buildi...

  18. Price-Cost Ratios in Higher Education: Subsidy Structure and Policy Implications

    Science.gov (United States)

    Xie, Yan

    2010-01-01

    The diversity of US institutions of higher education is manifested in many ways. This study looks at that diversity from the economic perspective by studying the subsidy structure through the distribution of institutional price-cost ratio (PCR), defined as the sum of net tuition price divided by total supplier cost and equals to one minus…

  19. Higher cost of implementing Xpert(®) MTB/RIF in Ugandan peripheral settings: implications for cost-effectiveness.

    Science.gov (United States)

    Hsiang, E; Little, K M; Haguma, P; Hanrahan, C F; Katamba, A; Cattamanchi, A; Davis, J L; Vassall, A; Dowdy, D

    2016-09-01

    Initial cost-effectiveness evaluations of Xpert(®) MTB/RIF for tuberculosis (TB) diagnosis have not fully accounted for the realities of implementation in peripheral settings. To evaluate costs and diagnostic outcomes of Xpert testing implemented at various health care levels in Uganda. We collected empirical cost data from five health centers utilizing Xpert for TB diagnosis, using an ingredients approach. We reviewed laboratory and patient records to assess outcomes at these sites and10 sites without Xpert. We also estimated incremental cost-effectiveness of Xpert testing; our primary outcome was the incremental cost of Xpert testing per newly detected TB case. The mean unit cost of an Xpert test was US$21 based on a mean monthly volume of 54 tests per site, although unit cost varied widely (US$16-58) and was primarily determined by testing volume. Total diagnostic costs were 2.4-fold higher in Xpert clinics than in non-Xpert clinics; however, Xpert only increased diagnoses by 12%. The diagnostic costs of Xpert averaged US$119 per newly detected TB case, but were as high as US$885 at the center with the lowest volume of tests. Xpert testing can detect TB cases at reasonable cost, but may double diagnostic budgets for relatively small gains, with cost-effectiveness deteriorating with lower testing volumes.

  20. Cost-Cutting in Higher Education: Lessons Learned from Collaboration, Technology, and Outsourcing Initiatives. Draft.

    Science.gov (United States)

    Kaganoff, Tessa

    This document presents a review of cost-containment initiatives relevant to higher education institutions. Originally commissioned to examine cost containment initiatives carried out by institutions affiliated with the Foundation for Independent Higher Education (FIHE), the paper was expanded to include a sector-wide review of three types of…

  1. Spatial regulation of bone morphogenetic proteins (BMPs) in postnatal articular and growth plate cartilage

    Science.gov (United States)

    Garrison, Presley; Yue, Shanna; Hanson, Jeffrey; Baron, Jeffrey; Lui, Julian C.

    2017-01-01

    Articular and growth plate cartilage both arise from condensations of mesenchymal cells, but ultimately develop important histological and functional differences. Each is composed of three layers—the superficial, mid and deep zones of articular cartilage and the resting, proliferative and hypertrophic zones of growth plate cartilage. The bone morphogenetic protein (BMP) system plays an important role in cartilage development. A gradient in expression of BMP-related genes has been observed across growth plate cartilage, likely playing a role in zonal differentiation. To investigate the presence of a similar expression gradient in articular cartilage, we used laser capture microdissection (LCM) to separate murine growth plate and articular cartilage from the proximal tibia into their six constituent zones, and used a solution hybridization assay with color-coded probes (nCounter) to quantify mRNAs for 30 different BMP-related genes in each zone. In situ hybridization and immunohistochemistry were then used to confirm spatial expression patterns. Expression gradients for Bmp2 and 6 were observed across growth plate cartilage with highest expression in hypertrophic zone. However, intracellular BMP signaling, assessed by phospho-Smad1/5/8 immunohistochemical staining, appeared to be higher in the proliferative zone and prehypertrophic area than in hypertrophic zone, possibly due to high expression of Smad7, an inhibitory Smad, in the hypertrophic zone. We also found BMP expression gradients across the articular cartilage with BMP agonists primarily expressed in the superficial zone and BMP functional antagonists primarily expressed in the deep zone. Phospho-Smad1/5/8 immunohistochemical staining showed a similar gradient. In combination with previous evidence that BMPs regulate chondrocyte proliferation and differentiation, the current findings suggest that BMP signaling gradients exist across both growth plate and articular cartilage and that these gradients may

  2. Bully University? The Cost of Workplace Bullying and Employee Disengagement in American Higher Education

    Directory of Open Access Journals (Sweden)

    Leah P. Hollis

    2015-06-01

    Full Text Available Workplace bullying has a detrimental effect on employees, yet few studies have examined its impact on personnel in American higher education administration. Therefore, two central research questions guided this study: (a What is the extent of workplace bullying in higher education administration? and (b What is the cost of workplace bullying specifically to higher education administration? Participants from 175 four-year colleges and universities were surveyed to reveal that 62% of higher education administrators had experienced or witnessed workplace bullying in the 18 months prior to the study. Race and gender were not parameters considered in the sample. A total of 401 (n = 401 higher education respondents completed the instrument from various departments on a campus: academic affairs, student affairs, athletics, development/advancement, admissions/financial aid, information technology, arts faculty, sciences faculty, and executives. Employment disengagement served as the theoretical lens to analyze the financial cost to higher education when employees mentally disengage from organizational missions and objectives. With this lens, the study examined staff hours lost through employee disengagement and the associated costs.

  3. Positive Attitude toward Healthy Eating Predicts Higher Diet Quality at All Cost Levels of Supermarkets☆

    Science.gov (United States)

    Aggarwal, Anju; Monsivais, Pablo; Cook, Andrea J.; Drewnowski, Adam

    2014-01-01

    Shopping at low-cost supermarkets has been associated with higher obesity rates. This study examined whether attitudes toward healthy eating are independently associated with diet quality among shoppers at low-cost, medium-cost, and high-cost supermarkets. Data on socioeconomic status (SES), attitudes toward healthy eating, and supermarket choice were collected using a telephone survey of a representative sample of adult residents of King County, WA. Dietary intake data were based on a food frequency questionnaire. Thirteen supermarket chains were stratified into three categories: low, medium, and high cost, based on a market basket of 100 commonly eaten foods. Diet-quality measures were energy density, mean adequacy ratio, and total servings of fruits and vegetables. The analytical sample consisted of 963 adults. Multivariable regressions with robust standard error examined relations between diet quality, supermarket type, attitudes, and SES. Shopping at higher-cost supermarkets was associated with higher-quality diets. These associations persisted after adjusting for SES, but were eliminated after taking attitudinal measures into account. Supermarket shoppers with positive attitudes toward healthy eating had equally higher-quality diets, even if they shopped at low-, medium-, or high-cost supermarkets, independent of SES and other covariates. These findings imply that shopping at low-cost supermarkets does not prevent consumers from having high-quality diets, as long as they attach importance to good nutrition. Promoting nutrition-education strategies among supermarkets, particularly those catering to low-income groups, can help to improve diet quality. PMID:23916974

  4. Sustainable energy from biomass: Biomethane manufacturing plant location and distribution problem

    International Nuclear Information System (INIS)

    Wu, Bingqing; Sarker, Bhaba R.; Paudel, Krishna P.

    2015-01-01

    Highlights: • Optimal strategy to locate biogas reactor and allocating feedstock. • Nonlinear mixed integer programming problem structure. • Real world supply chain of biogas production system. • Considers construction cost, transportation and labor costs. • Novel heuristic improves efficiency to obtain optimal solution. - Abstract: As an environment-friendly and renewable energy source, biomethane plays a significant role in the supply of sustainable energy. To facilitate the decision-making process of where to build a biomethane production system (BMPS) and how to allocate the resources for the BMPS, this paper develops an analytical method to find the solutions to location and allocation problems by minimizing the supply chain cost of the BMPS. The BMPS consists of the local farms for providing feedstock, the hubs for collecting and storing feedstock from farms, and the reactors for producing biomethane from feedstock. A mixed integer nonlinear programming (MINLP) is introduced to model the supply chain by considering building, transportation, and labor costs. An alternative heuristic is proposed to obtain an optimal/sub-optimal solution from the MINLP. The validity of the proposed heuristic is proven by numerical examples that are abstracted from practical scenarios.

  5. Positive attitude toward healthy eating predicts higher diet quality at all cost levels of supermarkets.

    Science.gov (United States)

    Aggarwal, Anju; Monsivais, Pablo; Cook, Andrea J; Drewnowski, Adam

    2014-02-01

    Shopping at low-cost supermarkets has been associated with higher obesity rates. This study examined whether attitudes toward healthy eating are independently associated with diet quality among shoppers at low-cost, medium-cost, and high-cost supermarkets. Data on socioeconomic status (SES), attitudes toward healthy eating, and supermarket choice were collected using a telephone survey of a representative sample of adult residents of King County, WA. Dietary intake data were based on a food frequency questionnaire. Thirteen supermarket chains were stratified into three categories: low, medium, and high cost, based on a market basket of 100 commonly eaten foods. Diet-quality measures were energy density, mean adequacy ratio, and total servings of fruits and vegetables. The analytical sample consisted of 963 adults. Multivariable regressions with robust standard error examined relations between diet quality, supermarket type, attitudes, and SES. Shopping at higher-cost supermarkets was associated with higher-quality diets. These associations persisted after adjusting for SES, but were eliminated after taking attitudinal measures into account. Supermarket shoppers with positive attitudes toward healthy eating had equally higher-quality diets, even if they shopped at low-, medium-, or high-cost supermarkets, independent of SES and other covariates. These findings imply that shopping at low-cost supermarkets does not prevent consumers from having high-quality diets, as long as they attach importance to good nutrition. Promoting nutrition-education strategies among supermarkets, particularly those catering to low-income groups, can help to improve diet quality. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  6. Higher costs confirmed for US supercollider

    CERN Multimedia

    Vaughan, C

    1990-01-01

    American Secratary of Energy, James Watkins told Congress that the SSC will cost at least one to two billion dollars more than its estimated cost. He admitted that the final cost may be so high that the collider is not worth building (3 paragraphs).

  7. Efficiency, Costs, Rankings and Heterogeneity: The Case of US Higher Education

    Science.gov (United States)

    Agasisti, Tommaso; Johnes, Geraint

    2015-01-01

    Among the major trends in the higher education (HE) sector, the development of rankings as a policy and managerial tool is of particular relevance. However, despite the diffusion of these instruments, it is still not clear how they relate with traditional performance measures, like unit costs and efficiency scores. In this paper, we estimate a…

  8. Bully University? The Cost of Workplace Bullying and Employee Disengagement in American Higher Education

    OpenAIRE

    Leah P. Hollis

    2015-01-01

    Workplace bullying has a detrimental effect on employees, yet few studies have examined its impact on personnel in American higher education administration. Therefore, two central research questions guided this study: (a) What is the extent of workplace bullying in higher education administration? and (b) What is the cost of workplace bullying specifically to higher education administration? Participants from 175 four-...

  9. How Much Is Too Much? Controlling Administrative Costs through Effective Oversight. A Guide for Higher Education Trustees

    Science.gov (United States)

    Alacbay, Armand; Barden, Danielle

    2017-01-01

    With recent research from the Institute for Higher Education Policy showing that college is unaffordable for as many as 70% of working- and middle-class students, concerns about college costs are mounting. The cost of operating an institution of higher education, with very few exceptions, is reflected in the price of attendance that students,…

  10. Assessing the impacts of Best Management Practices on nitrate pollution in an agricultural dominated lowland catchment considering environmental protection versus economic development.

    Science.gov (United States)

    Haas, Marcelo B; Guse, Björn; Fohrer, Nicola

    2017-07-01

    Water quality is strongly affected by nitrate inputs in agricultural catchments. Best Management Practices (BMPs) are alternative practices aiming to mitigate the impacts derived from agricultural activities and to improve water quality. Management activities are influenced by different governmental policies like the Water Framework Directive (WFD) and the Renewable Energy Sources Act (EEG). Their distinct goals can be contrasting and hamper an integrated sustainable development. Both need to be addressed in the actual conjuncture in rural areas. Ecohydrological models like the SWAT model are important tools for land cover and land use changes investigation and the assessment of BMPs implementation effects on water quality. Thus, in this study, buffer strip, fertilization reduction and alternative crops were considered as BMPs and were implemented in the SWAT model for the Treene catchment. Their efficiency in terms of nitrate loads reduction related to implementation costs at the catchment scale was investigated. The practices correspond to the catchment conditions and are based on small and mid areal changes. Furthermore, the BMPs were evaluated from the perspective of ecologic and economic policies. The results evidenced different responses of the BMPs. The critical periods in winter were addressed by most of the BMPs. However, some practices like pasture land increase need to be implemented in greater area for better results in comparison to current activities. Furthermore, there is a greater nitrate reduction potential by combining BMPs containing fertilization reduction, buffer strips and soil coverage in winter. The discussion about efficiency showed the complexity of costs stipulation and the relation with arable land and yield losses. Furthermore, as the government policies can be divergent an integrated approach considering all the involved actors is important and seeks a sustainable development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Investment Evaluation of Higher Education through Cost-Benefit Analysis: Evidence from Adrar University-Algeria

    Science.gov (United States)

    Hocine, Benlaria; Sofiane, Mostéfaoui

    2017-01-01

    This study aims to measure the social and individual rates of return for investment in higher education at Adrar University. The approach adopted looks for investigating the costs and benefits of the human capital. The study found that the economic feasibility of investment in higher education exists at both the individual and social levels, where…

  12. Appraising the Cost Efficiency of Higher Technological and Vocational Education Institutions in Taiwan Using the Metafrontier Cost-Function Model

    Science.gov (United States)

    Lu, Yung-Hsiang; Chen, Ku-Hsieh

    2013-01-01

    This paper aims at appraising the cost efficiency and technology of institutions of higher technological and vocational education. Differing from conventional literature, it considers the potential influence of inherent discrepancies in output quality and characteristics of school systems for institutes of technology (ITs) and universities of…

  13. Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Selected Malaysian Adults

    Directory of Open Access Journals (Sweden)

    Ibnteesam Pondor

    2017-09-01

    Full Text Available Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI. DDC in Malaysian Ringgit (RM was calculated from dietary intake and national food prices. Linear regression models were fitted to determine associations between DDC and M-HEI scores and predictors of diet quality. The mean M-HEI score of respondents was 61.31 ± 10.88 and energy adjusted DDC was RM10.71/2000 kcal (USD 2.49. The highest quintile of adjusted DDC had higher M-HEI scores for all respondents (Q1: 57.14 ± 10.07 versus Q5: 63.26 ± 11.54, p = 0.001. There were also positive associations between DDC and M-HEI scores for fruits (p < 0.001 and vegetables (p = 0.017 for all respondents. Predictors of diet quality included carbohydrate (β = 0290; p < 0.001 and fat intakes (β = −0.242; p < 0.001 and energy adjusted DDC (β = 0.196; p < 0.001. Higher dietary cost is associated with healthy eating among Malaysian adults.

  14. Cheaper fuel and higher health costs among the poor in rural Nepal

    Energy Technology Data Exchange (ETDEWEB)

    Pant, Krishna Prasad [Ministry of Agriculture and Cooperatives, Vidhya Lane, Devnagar, Kathmandu (Nepal)], email: kppant@yahoo.com

    2012-03-15

    Biomass fuels are used by the majority of resource poor households in low-income countries. Though biomass fuels, such as dung-briquette and firewood are apparently cheaper than the modern fuels indoor pollution from burning biomass fuels incurs high health costs. But, the health costs of these conventional fuels, mostly being indirect, are poorly understood. To address this gap, this study develops probit regression models using survey data generated through interviews from households using either dung-briquette or biogas as the primary source of fuel for cooking. The study investigates factors affecting the use of dung-briquette, assesses its impact on human health, and estimates the associated household health costs. Analysis suggests significant effects of dung-briquette on asthma and eye diseases. Despite of the perception of it being a cheap fuel, the annual health cost per household due to burning dung-briquette (US$ 16.94) is 61.3% higher than the annual cost of biogas (US$ 10.38), an alternative cleaner fuel for rural households. For reducing the use of dung-briquette and its indirect health costs, the study recommends three interventions: (1) educate women and aboriginal people, in particular, and make them aware of the benefits of switching to biogas; (2) facilitate tree planting in communal as well as private lands; and (3) create rural employment and income generation opportunities.

  15. Optimization of economic load dispatch of higher order general cost polynomials and its sensitivity using modified particle swarm optimization

    International Nuclear Information System (INIS)

    Saber, Ahmed Yousuf; Chakraborty, Shantanu; Abdur Razzak, S.M.; Senjyu, Tomonobu

    2009-01-01

    This paper presents a modified particle swarm optimization (MPSO) for constrained economic load dispatch (ELD) problem. Real cost functions are more complex than conventional second order cost functions when multi-fuel operations, valve-point effects, accurate curve fitting, etc., are considering in deregulated changing market. The proposed modified particle swarm optimization (PSO) consists of problem dependent variable number of promising values (in velocity vector), unit vector and error-iteration dependent step length. It reliably and accurately tracks a continuously changing solution of the complex cost function and no extra concentration/effort is needed for the complex higher order cost polynomials in ELD. Constraint management is incorporated in the modified PSO. The modified PSO has balance between local and global searching abilities, and an appropriate fitness function helps to converge it quickly. To avoid the method to be frozen, stagnated/idle particles are reset. Sensitivity of the higher order cost polynomials is also analyzed visually to realize the importance of the higher order cost polynomials for the optimization of ELD. Finally, benchmark data sets and methods are used to show the effectiveness of the proposed method. (author)

  16. Nutrient Application and Algal Blooms: Farmer Decisions Regarding the Use of Best Management Practices in Lake Erie's Maumee River Watershed

    Science.gov (United States)

    Heeren, A.; Toman, E.; Wilson, R. S.; Martin, J.

    2016-12-01

    Lake Erie is the most productive of the Great Lakes. However, harmful algal blooms (HABs) caused by nutrient run-off threaten the lake. Experts have proposed numerous best management practices (BMPs) designed to reduce nutrient and sediment run-off. However, for these practices to be effective at reducing HABs, a significant portion of farmers and landowners within Lake Erie's watersheds have to first adopt and implement these practices. In order to better understand how farmers and landowners make decisions about whether or not to adopt and implement BMPs we conducted a series of focus groups and a mail survey of Lake Erie's largest watershed. We found that many farmers were supportive of adopting BMPs. For example, 60% of farmers in the watershed have already adopted using grid soil sampling while another 30% are willing to adopt the practice in the future. However, other practices were less popular, for example, only 18% of farmers had already adopted cover crops. Farmers also expressed several reservations about adopting some BMPs. For example, farmers were concerned about the costs of some BMPs, such as cover crops and drainage management systems, and how such practices might interfere with the planting of subsequent crops. Our research has several implications for reducing nutrient production by promoting BMPs. First, we identified potential concerns and limitations farmers faced in implementing specific BMPs. For example, conservationists can design future programs and communication efforts to target these specific concerns. Second, through examining the socio-psychological and cognitive characteristics that influence farmer decision-making, we identified that willingness to adopt nutrient BMPs is association with how strongly a farmer identifies with conservation and how effective they believed the BMP was at reducing run-off. Messages and information about BMPs may be more effective if they are framed in a way that aligns with identities and beliefs about

  17. Proteínas morfogenéticas óseas (BMPs): Efecto de la proteína osteogénica-1 (OP-l/BMP-7) en la condrogénesis y osteogenesis

    OpenAIRE

    Peris Serra, José Luis; Prat Pastor, Jaime; Dejoz, Ricardo; Comín Clavijo, Mario; Atienza Vicente, Carlos M.; Barreda, J. S.; Roger, I.; Reig, C.; Vera Luna, Pedro

    1996-01-01

    En la actualidad, los estudios sobre biología molecular han facilitado el análisis de ciertos factores de transformación del crecimiento tipo ß(TGF-ß)I, entre los que destaca una familia de proteínas morfogenéticas óseas (BMPs). Las técnicas de ingeniería genética han permitido replicar alguno de estos factores y localizar los genes que codifican dichas proteínas. La proteína osteogenics-1 (OP-1) ha sido caracterizada y sintetizada in vitro y muestra un elevado potencial osteog...

  18. Optimal implementation of best management practices to improve agricultural hydrology and water quality

    Science.gov (United States)

    Liu, Y.; Engel, B.; Collingsworth, P.; Pijanowski, B. C.

    2017-12-01

    Nutrient loading from the Maumee River watershed is a significant reason for the harmful algal blooms (HABs) problem in Lake Erie. Strategies to reduce nutrient loading from agricultural areas in the Maumee River watershed need to be explored. Best management practices (BMPs) are popular approaches for improving hydrology and water quality. Various scenarios of BMP implementation were simulated in the AXL watershed (an agricultural watershed in Maumee River watershed) using Soil and Water Assessment Tool (SWAT) and a new BMP cost tool to explore the cost-effectiveness of the practices. BMPs of interest included vegetative filter strips, grassed waterways, blind inlets, grade stabilization structures, wetlands, no-till, nutrient management, residue management, and cover crops. The following environmental concerns were considered: streamflow, Total Phosphorous (TP), Dissolved Reactive Phosphorus (DRP), Total Kjeldahl Nitrogen (TKN), and Nitrate+Nitrite (NOx). To obtain maximum hydrological and water quality benefits with minimum cost, an optimization tool was developed to optimally select and place BMPs by connecting SWAT, the BMP cost tool, and optimization algorithms. The optimization tool was then applied in AXL watershed to explore optimization focusing on critical areas (top 25% of areas with highest runoff volume/pollutant loads per area) vs. all areas of the watershed, optimization using weather data for spring (March to July, due to the goal of reducing spring phosphorus in watershed management plan) vs. full year, and optimization results of implementing BMPs to achieve the watershed management plan goal (reducing 2008 TP levels by 40%). The optimization tool and BMP optimization results can be used by watershed groups and communities to solve hydrology and water quality problems.

  19. Multi-Product Total Cost of Function for Higher Education: A Case of Bible Colleges.

    Science.gov (United States)

    Koshal, Rajindar K.; Koshal, Manjulika; Gupta, Ashok

    2001-01-01

    This study empirically estimates a multiproduct total cost function and output relationship for comprehensive U.S. universities. Statistical results for 184 Bible colleges suggest that there are both economies of scale and of scope in higher education. Additionally, product-specific economies of scope exist for all output levels and activities.…

  20. Spatio-temporal effects of low impact development practices

    Science.gov (United States)

    Gilroy, Kristin L.; McCuen, Richard H.

    2009-04-01

    SummaryThe increase in land development and urbanization experienced in the US and worldwide is causing environmental degradation. Traditional off-site stormwater management does not protect small streams. To mitigate the negative effects of land development, best management practices (BMPs) are being implemented into stormwater management policies for the purposes of controlling minor flooding and improving water quality. Unfortunately, the effectiveness of BMPs has not been extensively studied. The purpose of this research was to analyze the effects of both location and quantity of two types of BMPs: cisterns and bioretention pits. A spatio-temporal model of a microwatershed was developed to determine the effects of BMPs on single-family, townhome, and commercial lots. The effects of development and the BMPs on peak runoff rates and volumes were compared to pre-development conditions. The results show that cisterns alone are capable of controlling rooftop runoff for small storms. Both the spatial location and the volume of BMP storage on a microwatershed influences the effectiveness of BMPs. The volume of BMP storage is positively correlated to the percent reduction in the peak discharge rate and total runoff volume; however, location is a factor in the peak reduction and a maximum volume of effective storage for both hydrologic metrics does exist. These results provide guidelines for developing stormwater management policies that can potentially reduce pollution of first-order streams, lower the cost and maintenance requirements, enhance aesthetics, and increase safety.

  1. Public Concepts of the Values and Costs of Higher Education, 1963-1974. A Preliminary Analysis.

    Science.gov (United States)

    Minor, Michael J.; Murray, James R.

    Statistical data are presented on interviews conducted through the Continuous National Survey (CNS) at the National Opinion Research Center in Chicago and based on results reprinted from "Public Concepts of the Values and Costs of Higher Education," by Angus Campbell and William C. Eckerman. The CNS results presented in this report are…

  2. Higher threat avoidance costs reduce avoidance behaviour which in turn promotes fear extinction in humans.

    Science.gov (United States)

    Rattel, Julina A; Miedl, Stephan F; Blechert, Jens; Wilhelm, Frank H

    2017-09-01

    Theoretical models specifying the underlying mechanisms of the development and maintenance of anxiety and related disorders state that fear responses acquired through classical Pavlovian conditioning are maintained by repeated avoidance behaviour; thus, it is assumed that avoidance prevents fear extinction. The present study investigated behavioural avoidance decisions as a function of avoidance costs in a naturalistic fear conditioning paradigm. Ecologically valid avoidance costs - manipulated between participant groups - were represented via time-delays during a detour in a gamified computer task. After differential acquisitions of shock-expectancy to a predictive conditioned stimulus (CS+), participants underwent extinction where they could either take a risky shortcut, while anticipating shock signaled by the CS+, or choose a costly avoidance option (lengthy detour); thus, they were faced with an approach-avoidance conflict. Groups with higher avoidance costs (longer detours) showed lower proportions of avoiders. Avoiders gave heightened shock-expectancy ratings post-extinction, demonstrating 'protecting from extinction', i.e. failure to extinguish. Moreover, there was an indirect effect of avoidance costs on protection from extinction through avoidance behaviour. No moderating role of trait-anxiety was found. Theoretical implications of avoidance behaviour are discussed, considering the involvement of instrumental learning in the maintenance of fear responses. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Lowering the Cost Barrier to Higher Education for Undocumented Students: A Promising University-Level Intervention

    Science.gov (United States)

    Thangasamy, Andrew; Horan, Deborah

    2016-01-01

    Undocumented students, many of Hispanic origin, face among the strictest cost barriers to higher education in the United States. Lack of legal status excludes them from most state and all federal financial aid programs. Furthermore, most states require them to pay out-of-state tuition rates at publicly supported institutions. In a new direction,…

  4. Evaluating the effectiveness of management practices on hydrology and water quality at watershed scale with a rainfall-runoff model.

    Science.gov (United States)

    Liu, Yaoze; Bralts, Vincent F; Engel, Bernard A

    2015-04-01

    The adverse influence of urban development on hydrology and water quality can be reduced by applying best management practices (BMPs) and low impact development (LID) practices. This study applied green roof, rain barrel/cistern, bioretention system, porous pavement, permeable patio, grass strip, grassed swale, wetland channel, retention pond, detention basin, and wetland basin, on Crooked Creek watershed. The model was calibrated and validated for annual runoff volume. A framework for simulating BMPs and LID practices at watershed scales was created, and the impacts of BMPs and LID practices on water quantity and water quality were evaluated with the Long-Term Hydrologic Impact Assessment-Low Impact Development 2.1 (L-THIA-LID 2.1) model for 16 scenarios. The various levels and combinations of BMPs/LID practices reduced runoff volume by 0 to 26.47%, Total Nitrogen (TN) by 0.30 to 34.20%, Total Phosphorus (TP) by 0.27 to 47.41%, Total Suspended Solids (TSS) by 0.33 to 53.59%, Lead (Pb) by 0.30 to 60.98%, Biochemical Oxygen Demand (BOD) by 0 to 26.70%, and Chemical Oxygen Demand (COD) by 0 to 27.52%. The implementation of grass strips in 25% of the watershed where this practice could be applied was the most cost-efficient scenario, with cost per unit reduction of $1m3/yr for runoff, while cost for reductions of two pollutants of concern was $445 kg/yr for Total Nitrogen (TN) and $4871 kg/yr for Total Phosphorous (TP). The scenario with very high levels of BMP and LID practice adoption (scenario 15) reduced runoff volume and pollutant loads from 26.47% to 60.98%, and provided the greatest reduction in runoff volume and pollutant loads among all scenarios. However, this scenario was not as cost-efficient as most other scenarios. The L-THIA-LID 2.1 model is a valid tool that can be applied to various locations to help identify cost effective BMP/LID practice plans at watershed scales. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Prediction of higher cost of antiretroviral therapy (ART) according to clinical complexity. A validated clinical index.

    Science.gov (United States)

    Velasco, Cesar; Pérez, Inaki; Podzamczer, Daniel; Llibre, Josep Maria; Domingo, Pere; González-García, Juan; Puig, Inma; Ayala, Pilar; Martín, Mayte; Trilla, Antoni; Lázaro, Pablo; Gatell, Josep Maria

    2016-03-01

    The financing of antiretroviral therapy (ART) is generally determined by the cost incurred in the previous year, the number of patients on treatment, and the evidence-based recommendations, but not the clinical characteristics of the population. To establish a score relating the cost of ART and patient clinical complexity in order to understand the costing differences between hospitals in the region that could be explained by the clinical complexity of their population. Retrospective analysis of patients receiving ART in a tertiary hospital between 2009 and 2011. Factors potentially associated with a higher cost of ART were assessed by bivariate and multivariate analysis. Two predictive models of "high-cost" were developed. The normalized estimated (adjusted for the complexity scores) costs were calculated and compared with the normalized real costs. In the Hospital Index, 631 (16.8%) of the 3758 patients receiving ART were responsible for a "high-cost" subgroup, defined as the highest 25% of spending on ART. Baseline variables that were significant predictors of high cost in the Clinic-B model in the multivariate analysis were: route of transmission of HIV, AIDS criteria, Spanish nationality, year of initiation of ART, CD4+ lymphocyte count nadir, and number of hospital admissions. The Clinic-B score ranged from 0 to 13, and the mean value (5.97) was lower than the overall mean value of the four hospitals (6.16). The clinical complexity of the HIV patient influences the cost of ART. The Clinic-B and Clinic-BF scores predicted patients with high cost of ART and could be used to compare and allocate costs corrected for the patient clinical complexity. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  6. Effects of distributed and centralized stormwater best management practices and land cover on urban stream hydrology at the catchment scale

    Science.gov (United States)

    Loperfido, J. V.; Noe, Gregory B.; Jarnagin, S. Taylor; Hogan, Dianna M.

    2014-11-01

    Urban stormwater runoff remains an important issue that causes local and regional-scale water quantity and quality issues. Stormwater best management practices (BMPs) have been widely used to mitigate runoff issues, traditionally in a centralized manner; however, problems associated with urban hydrology have remained. An emerging trend is implementation of BMPs in a distributed manner (multi-BMP treatment trains located on the landscape and integrated with urban design), but little catchment-scale performance of these systems have been reported to date. Here, stream hydrologic data (March, 2011-September, 2012) are evaluated in four catchments located in the Chesapeake Bay watershed: one utilizing distributed stormwater BMPs, two utilizing centralized stormwater BMPs, and a forested catchment serving as a reference. Among urban catchments with similar land cover, geology and BMP design standards (i.e. 100-year event), but contrasting placement of stormwater BMPs, distributed BMPs resulted in: significantly greater estimated baseflow, a higher minimum precipitation threshold for stream response and maximum discharge increases, better maximum discharge control for small precipitation events, and reduced runoff volume during an extreme (1000-year) precipitation event compared to centralized BMPs. For all catchments, greater forest land cover and less impervious cover appeared to be more important drivers than stormwater BMP spatial pattern, and caused lower total, stormflow, and baseflow runoff volume; lower maximum discharge during typical precipitation events; and lower runoff volume during an extreme precipitation event. Analysis of hydrologic field data in this study suggests that both the spatial distribution of stormwater BMPs and land cover are important for management of urban stormwater runoff. In particular, catchment-wide application of distributed BMPs improved stream hydrology compared to centralized BMPs, but not enough to fully replicate forested

  7. Effects of distributed and centralized stormwater best management practices and land cover on urban stream hydrology at the catchment scale

    Science.gov (United States)

    Loperfido, John V.; Noe, Gregory B.; Jarnagin, S. Taylor; Hogan, Dianna M.

    2014-01-01

    Urban stormwater runoff remains an important issue that causes local and regional-scale water quantity and quality issues. Stormwater best management practices (BMPs) have been widely used to mitigate runoff issues, traditionally in a centralized manner; however, problems associated with urban hydrology have remained. An emerging trend is implementation of BMPs in a distributed manner (multi-BMP treatment trains located on the landscape and integrated with urban design), but little catchment-scale performance of these systems have been reported to date. Here, stream hydrologic data (March, 2011–September, 2012) are evaluated in four catchments located in the Chesapeake Bay watershed: one utilizing distributed stormwater BMPs, two utilizing centralized stormwater BMPs, and a forested catchment serving as a reference. Among urban catchments with similar land cover, geology and BMP design standards (i.e. 100-year event), but contrasting placement of stormwater BMPs, distributed BMPs resulted in: significantly greater estimated baseflow, a higher minimum precipitation threshold for stream response and maximum discharge increases, better maximum discharge control for small precipitation events, and reduced runoff volume during an extreme (1000-year) precipitation event compared to centralized BMPs. For all catchments, greater forest land cover and less impervious cover appeared to be more important drivers than stormwater BMP spatial pattern, and caused lower total, stormflow, and baseflow runoff volume; lower maximum discharge during typical precipitation events; and lower runoff volume during an extreme precipitation event. Analysis of hydrologic field data in this study suggests that both the spatial distribution of stormwater BMPs and land cover are important for management of urban stormwater runoff. In particular, catchment-wide application of distributed BMPs improved stream hydrology compared to centralized BMPs, but not enough to fully replicate forested

  8. Exploring perceptions and beliefs about the cost of fruit and vegetables and whether they are barriers to higher consumption.

    Science.gov (United States)

    Chapman, Kathryn; Goldsbury, David; Watson, Wendy; Havill, Michelle; Wellard, Lyndal; Hughes, Clare; Bauman, Adrian; Allman-Farinelli, Margaret

    2017-06-01

    Fruit and vegetable (F&V) consumption is below recommendations, and cost may be a barrier to meeting recommendations. Limited evidence exists on individual perceptions about the cost, actual spending and consumption of F&V. This study investigated perceptions and beliefs about cost of F&V and whether this is a barrier to higher consumption. An online survey of Australian adults (n = 2474) measured F&V consumption; expenditure on F&V and food; and perceived barriers to consumption. Multivariable logistic regression examined associations between participants' responses about cost of F&V and demographic factors, and with actual consumption and expenditure on F&V. Cost was identified as a barrier for 29% of people not meeting recommended fruit servings and for 14% of people not meeting recommendations for vegetables. Cost was a more common barrier for those on lower incomes (fruit aOR 1.89; 95% CI 1.20-2.98 and vegetables aOR 2.94; 95% CI 1.97-4.39) and less common for older participants (fruit aOR 0.33; 95% CI 0.17-0.62 and vegetables aOR 0.31; 95% CI 0.18-0.52). There was no association between the perceived barriers and actual F&V spending. Twenty percent of participants said F&V were not affordable; 39% said cost made it difficult to buy F&V, and for 23% the cost of F&V meant they bought less than desired. A minority reported F&V were not affordable where they shopped and that cost was a barrier to higher consumption. However, it is apparent that young adults and those on low incomes eat less than they would like because of cost. Strategies that remove financial impediments to consumption are indicated for these population sub-groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Farm-system modeling to evaluate environmental losses, profitability, and best management practice cost-effectiveness

    Science.gov (United States)

    To meet Chesapeake Bay Total Maximum Daily Load requirements for agricultural pollution, conservation districts and farmers are tasked with implementing best management practices (BMPs) that reduce farm losses of nutrients and sediment. The importance of the agricultural industry to the regional eco...

  10. Manipulative therapy in addition to usual medical care accelerates recovery of shoulder complaints at higher costs: economic outcomes of a randomized trial

    Directory of Open Access Journals (Sweden)

    Bergman Gert JD

    2010-09-01

    Full Text Available Abstract Background Shoulder complaints are common in primary care and have unfavourable long term prognosis. Our objective was to evaluate the clinical effectiveness of manipulative therapy of the cervicothoracic spine and the adjacent ribs in addition to usual medical care (UMC by the general practitioner in the treatment of shoulder complaints. Methods This economic evaluation was conducted alongside a randomized trial in primary care. Included were 150 patients with shoulder complaints and a dysfunction of the cervicothoracic spine and adjacent ribs. Patients were treated with UMC (NSAID's, corticosteroid injection or referral to physical therapy and were allocated at random (yes/no to manipulative therapy (manipulation and mobilization. Patient perceived recovery, severity of main complaint, shoulder pain, disability and general health were outcome measures. Data about direct and indirect costs were collected by means of a cost diary. Results Manipulative therapy as add-on to UMC accelerated recovery on all outcome measures included. At 26 weeks after randomization, both groups reported similar recovery rates (41% vs. 38%, but the difference between groups in improvement of severity of the main complaint, shoulder pain and disability sustained. Compared to the UMC group the total costs were higher in the manipulative group (€1167 vs. €555. This is explained mainly by the costs of the manipulative therapy itself and the higher costs due sick leave from work. The cost effectiveness ratio showed that additional manipulative treatment is more costly but also more effective than UMC alone. The cost-effectiveness acceptability curve shows that a 50%-probability of recovery with AMT within 6 months after initiation of treatment is achieved at €2876. Conclusion Manipulative therapy in addition to UMC accelerates recovery and is more effective than UMC alone on the long term, but is associated with higher costs. International Standard

  11. Differing Levels of Forestry Best Management Practices at Stream Crossing Structures Affect Sediment Delivery and Installation Costs

    Directory of Open Access Journals (Sweden)

    Brian C. Morris

    2016-03-01

    Full Text Available Forestry best management practices (BMPs are used to reduce sedimentation from forest stream crossings. Three BMP treatments (BMP−, BMP-std, and BMP+ were applied to three forest road stream crossings (bridge, culvert, and ford. BMP− did not meet existing BMP guidelines, BMP-std met standard recommendations, and BMP+ treatments exceeded recommendations. Following BMP applications, three simulated rainfall intensities (low, medium, and high were applied in order to evaluate sediment delivery from crossing type and BMP level. During rainfall simulation, sediment concentrations (mg/L were collected with automated samplers and discharge (L/s was estimated to calculate total sediment loading. Costs of stream crossings and BMP levels were also quantified. Mean sediment associated with the three stream crossings were 3.38, 1.87, and 0.64 Mg for the BMP−, BMP-std, and BMP+ levels, respectively. Ford, culvert, and bridge crossings produced 13.04, 12.95, and 0.17 Mg of sediment during construction, respectively. BMP enhancement was more critical for sediment control at the culvert and ford crossings than at the bridge. Respective costs for BMP−, BMP-std, and BMP+ levels were $5,368, $5,658, and $5,858 for the bridge; $3,568, $4,166 and $4,595 for the culvert; and $180, $420 and $1,903 for the ford. Costs and sediment values suggest that current standard BMP levels effectively reduce stream sediment while minimizing costs.

  12. Bmps and id2a act upstream of Twist1 to restrict ectomesenchyme potential of the cranial neural crest.

    Directory of Open Access Journals (Sweden)

    Ankita Das

    Full Text Available Cranial neural crest cells (CNCCs have the remarkable capacity to generate both the non-ectomesenchyme derivatives of the peripheral nervous system and the ectomesenchyme precursors of the vertebrate head skeleton, yet how these divergent lineages are specified is not well understood. Whereas studies in mouse have indicated that the Twist1 transcription factor is important for ectomesenchyme development, its role and regulation during CNCC lineage decisions have remained unclear. Here we show that two Twist1 genes play an essential role in promoting ectomesenchyme at the expense of non-ectomesenchyme gene expression in zebrafish. Twist1 does so by promoting Fgf signaling, as well as potentially directly activating fli1a expression through a conserved ectomesenchyme-specific enhancer. We also show that Id2a restricts Twist1 activity to the ectomesenchyme lineage, with Bmp activity preferentially inducing id2a expression in non-ectomesenchyme precursors. We therefore propose that the ventral migration of CNCCs away from a source of Bmps in the dorsal ectoderm promotes ectomesenchyme development by relieving Id2a-dependent repression of Twist1 function. Together our model shows how the integration of Bmp inhibition at its origin and Fgf activation along its migratory route would confer temporal and spatial specificity to the generation of ectomesenchyme from the neural crest.

  13. Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Selected Malaysian Adults.

    Science.gov (United States)

    Pondor, Ibnteesam; Gan, Wan Ying; Appannah, Geeta

    2017-09-16

    Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC) in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ) and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI). DDC in Malaysian Ringgit (RM) was calculated from dietary intake and national food prices. Linear regression models were fitted to determine associations between DDC and M-HEI scores and predictors of diet quality. The mean M-HEI score of respondents was 61.31 ± 10.88 and energy adjusted DDC was RM10.71/2000 kcal (USD 2.49). The highest quintile of adjusted DDC had higher M-HEI scores for all respondents (Q1: 57.14 ± 10.07 versus Q5: 63.26 ± 11.54, p = 0.001). There were also positive associations between DDC and M-HEI scores for fruits ( p diet quality included carbohydrate (β = 0290; p healthy eating among Malaysian adults.

  14. Endoscopic third ventriculostomy has no higher costs than ventriculoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Benicio Oton de Lima

    2014-07-01

    Full Text Available Objective: To evaluate the cost of endoscopic third ventriculostomy (ETV compared to ventriculoperitoneal shunt (VPS in the treatment of hydrocephalus in children. Method: We studied 103 children with hydrocephalus, 52 of which were treated with ETV and 51 with VPS in a prospective cohort. Treatment costs were compared within the first year after surgery, including subsequent surgery or hospitalization. Results: Twenty (38.4% of the 52 children treated with VPS needed another procedure due to shunt failure, compared to 11 (21.5% of 51 children in the ETV group. The average costs per patient in the group treated with ETV was USD$ 2,177,66±517.73 compared to USD$ 2,890.68±2,835.02 for the VPS group. Conclusions: In this series there was no significant difference in costs between the ETV and VPS groups.

  15. The Cost-Accounting Mechanism in Higher Educational Institutions.

    Science.gov (United States)

    Lukoshkin, A. P.; Min'ko, E. V.

    1990-01-01

    Examines the need to increase expenditures per student at Soviet technical institutes. Proposes seeking financial assistance from enterprises employing technical specialists. Outlines an experimental program in cost accounting. Suggests stipend and wage allotments and explains some of the contractual obligations involved. (CH)

  16. Influence of land development on stormwater runoff from a mixed land use and land cover catchment.

    Science.gov (United States)

    Paule-Mercado, M A; Lee, B Y; Memon, S A; Umer, S R; Salim, I; Lee, C-H

    2017-12-01

    Mitigating for the negative impacts of stormwater runoff is becoming a concern due to increased land development. Understanding how land development influences stormwater runoff is essential for sustainably managing water resources. In recent years, aggregate low impact development-best management practices (LID-BMPs) have been implemented to reduce the negative impacts of stormwater runoff on receiving water bodies. This study used an integrated approach to determine the influence of land development and assess the ecological benefits of four aggregate LID-BMPs in stormwater runoff from a mixed land use and land cover (LULC) catchment with ongoing land development. It used data from 2011 to 2015 that monitored 41 storm events and monthly LULC, and a Personalized Computer Storm Water Management Model (PCSWMM). The four aggregate LID-BMPs are: ecological (S1), utilizing pervious covers (S2), and multi-control (S3) and (S4). These LID-BMPs were designed and distributed in the study area based on catchment characteristics, cost, and effectiveness. PCSWMM was used to simulate the monitored storm events from 2014 (calibration: R 2 and NSE>0.5; RMSE 0.5; RMSE runoff data and LULC change patterns (only 2015 for LID-BMPs) were used. Results show that the expansion of bare land and impervious cover, soil alteration, and high amount of precipitation influenced the stormwater runoff variability during different phases of land development. The four aggregate LID-BMPs reduced runoff volume (34%-61%), peak flow (6%-19%), and pollutant concentrations (53%-83%). The results of this study, in addition to supporting local LULC planning and land development activities, also could be applied to input data for empirical modeling, and designing sustainable stormwater management guidelines and monitoring strategies. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Understanding perceptions of stakeholder groups about Forestry Best Management Practices in Georgia.

    Science.gov (United States)

    Tumpach, Chantal; Dwivedi, Puneet; Izlar, Robert; Cook, Chase

    2018-05-01

    Forestry Best Management Practices (BMPs) are critical in ensuring sustainable forest management in the United States because of their effectiveness in protecting water quality, reducing soil erosion, maintaining riparian habitat, and sustaining site productivity. The success of forestry BMPs depends heavily on coordination among primary stakeholder groups. It is important to understand perceptions of such groups for a successful forest policy formulation. We used the SWOT-AHP (Strengths, Weaknesses, Opportunities, and Threats analysis with the Analytical Hierarchy Process) framework to assess perceptions of three stakeholder groups (loggers, landowners, agency foresters) about forestry BMPs in Georgia, the largest roundwood producing state in the United States. The agency and logger stakeholder groups gave the highest priority to improved reputation under the strength category, whereas the landowner stakeholder group perceived sustainable forestry as the highest priority under the same category. Lack of landowner education was the highest priority under the weakness category for landowner and agency stakeholder groups, whereas the logger stakeholder group selected lack of trained personnel as the highest priority under the same category. Agency and landowner stakeholder groups gave the highest priority to training and education while loggers indicated maintenance of forest-based environmental benefits as their highest priority under the opportunity category. Finally, landowners and agency stakeholder groups perceived more regulations and restrictions as most significant in the threat category whereas the logger stakeholder group was most concerned about the insufficient accounting of cost sharing under the same category. Overall, selected stakeholder groups recognize the importance of forestry BMPs and had positive perceptions about them. A collaborative approach based on continuous feedback can streamline expectations of stakeholder groups about forestry BMPs in

  18. Measuring the Cost of Quality in Higher Education: A Faculty Perspective

    Science.gov (United States)

    Ruhupatty, LeRoy; Maguad, Ben A.

    2015-01-01

    Most critical activities in colleges and universities are driven by financial considerations. It is thus important that revenues are found to support these activities or ways identified to streamline costs. One way to cut cost is to improve the efficiency of schools to address the issue of poor quality. In this paper, the cost of poor quality in…

  19. 76 FR 16818 - Central Valley Project Improvement Act, Standard Criteria for Ag and Urban Water Management Plans

    Science.gov (United States)

    2011-03-25

    ... Valley Project water conservation best management practices (BMPs) that shall develop Criteria for... project contractors using best available cost- effective technology and best management practices.'' The... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Standard...

  20. Evaluation and Analysis of Regional Best Management Practices in San Diego, California (USA)

    Science.gov (United States)

    Flint, K.; Kinoshita, A. M.

    2017-12-01

    In urban areas, surface water quality is often impaired due to pollutants transported by stormwater runoff. To maintain and improve surface water quality, the United States Clean Water Act (CWA) requires an evaluation of available water quality information to develop a list of impaired water bodies and establish contaminant restrictions. Structural Best Management Practices (BMPs) are designed to reduce runoff volume and/or pollutant concentrations to comply with CWA requirements. Local level policy makers and managers require an improved understanding of the costs and benefits associated with BMP installation, performance, and maintenance. The International Stormwater BMP Database (Database) is an online platform for submittal of information about existing BMPs, such as cost, design details, and statistical analysis of influent and effluent pollutant concentrations. While the Database provides an aggregation of data which supports analysis of overall BMP performance at international and national scales, the sparse spatial distribution of the data is not suitable for regional and local analysis. This research conducts an extensive review of local inventory and spatial analysis of existing permanent BMPs throughout the San Diego River watershed in California, USA. Information collected from cities within the San Diego River watershed will include BMP types, locations, dates of installation, costs, expected removal efficiencies, monitoring data, and records of maintenance. Aggregating and mapping this information will facilitate BMP evaluation. Specifically, the identification of spatial trends, inconsistencies in BMP performances, and gaps in current records. Regression analysis will provide insight into the nature and significance of correlations between BMP performance and physical characteristics such as land use, soil type, and proximity to impaired waters. This analysis will also result in a metric of relative BMP performance and will provide a basis for future

  1. Can a Costly Intervention Be Cost-effective?

    Science.gov (United States)

    Foster, E. Michael; Jones, Damon

    2009-01-01

    Objectives To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Design Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. Results Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Conclusions Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations. PMID:17088509

  2. Do Medicare Advantage Plans Minimize Costs? Investigating the Relationship Between Benchmarks, Costs, and Rebates.

    Science.gov (United States)

    Zuckerman, Stephen; Skopec, Laura; Guterman, Stuart

    2017-12-01

    Medicare Advantage (MA), the program that allows people to receive their Medicare benefits through private health plans, uses a benchmark-and-bidding system to induce plans to provide benefits at lower costs. However, prior research suggests medical costs, profits, and other plan costs are not as low under this system as they might otherwise be. To examine how well the current system encourages MA plans to bid their lowest cost by examining the relationship between costs and bonuses (rebates) and the benchmarks Medicare uses in determining plan payments. Regression analysis using 2015 data for HMO and local PPO plans. Costs and rebates are higher for MA plans in areas with higher benchmarks, and plan costs vary less than benchmarks do. A one-dollar increase in benchmarks is associated with 32-cent-higher plan costs and a 52-cent-higher rebate, even when controlling for market and plan factors that can affect costs. This suggests the current benchmark-and-bidding system allows plans to bid higher than local input prices and other market conditions would seem to warrant. To incentivize MA plans to maximize efficiency and minimize costs, Medicare could change the way benchmarks are set or used.

  3. The ABCs of Activity-Based Costing: A Cost Containment and Reallocation Tool.

    Science.gov (United States)

    Turk, Frederick J.

    1992-01-01

    This article describes activity-based costing (ABC) and how this tool may help management understand the costs of major activities and identify possible alternatives. Also discussed are the traditional costing systems used by higher education and ways of applying ABC to higher education. (GLR)

  4. Suburban watershed nitrogen retention: Estimating the effectiveness of stormwater management structures

    Science.gov (United States)

    Koch, Benjamin J.; Febria, Catherine M.; Cooke, Roger M.; Hosen, Jacob D.; Baker, Matthew E.; Colson, Abigail R.; Filoso, Solange; Hayhoe, Katharine; Loperfido, J. V.; Stoner, Anne M.K.; Palmer, Margaret A.

    2015-01-01

    Excess nitrogen (N) is a primary driver of freshwater and coastal eutrophication globally, and urban stormwater is a rapidly growing source of N pollution. Stormwater best management practices (BMPs) are used widely to remove excess N from runoff in urban and suburban areas, and are expected to perform under a wide variety of environmental conditions. Yet the capacity of BMPs to retain excess N varies; and both the variation and the drivers thereof are largely unknown, hindering the ability of water resource managers to meet water quality targets in a cost-effective way. Here, we use structured expert judgment (SEJ), a performance-weighted method of expert elicitation, to quantify the uncertainty in BMP performance under a range of site-specific environmental conditions and to estimate the extent to which key environmental factors influence variation in BMP performance. We hypothesized that rain event frequency and magnitude, BMP type and size, and physiographic province would significantly influence the experts’ estimates of N retention by BMPs common to suburban Piedmont and Coastal Plain watersheds of the Chesapeake Bay region.

  5. The Cost of Chaos in the Curriculum. Perspectives on Higher Education

    Science.gov (United States)

    Capaldi Phillips, Elizabeth D.; Poliakoff, Michael B.

    2015-01-01

    ACTA's report "The Cost of Chaos in the Curriculum" reveals that the vast array of course choices given to college students is a cause of exploding costs and poor academic outcomes. And a bloated undergraduate curriculum is particularly detrimental to the success of students from lower socioeconomic backgrounds. The report documents how…

  6. On Account--table Combined Method for Education Cost Calculation of Higher Vocational Colleges%高职院校教育成本帐表结合法的探析

    Institute of Scientific and Technical Information of China (English)

    韩征

    2012-01-01

    随着高职院校各项教育费用支出的增加,教育成本逐渐受到人们的关注.为了科学核算高职院校教育成本,分析了高职院校现行核算方法不能客观反映教育成本的原因,明确了教育成本核算的基本会计假设和原则.以高职院校经费预算项目核算为基础,结合高职院校财务现状和办学特点,提出了帐表结合法核算高职院校教育成本.该方法采用项目帐和费用分配表相结合的模式,可科学核算高职院校教育成本.%With the increase of various education expenses of higher vocational colleges, educa-tion cost is gradually getting noticed by people. In order to calculate education cost of higher vo-cational colleges scientifically, this paper puts forward that current calculation method can not re-flect the education cost of higher vocational colleges objectively and clarifies basic accounting pos-tulate as well as principles of education cost calculation. Based on calculation of fund budget i-tems of higher vocational colleges, this paper puts forward account table combined method to calculate education cost of higher vocational colleges according to their financial situation and school-running characteristics. This method adopts the model combining item account with cost allocation table, which can calculate education cost of higher vocational colleges scientifically.

  7. National Variation in Urethroplasty Cost and Predictors of Extreme Cost: A Cost Analysis with Policy Implications

    OpenAIRE

    Harris, Catherine R.; Osterberg, E. Charles; Sanford, Thomas; Alwaal, Amjad; Gaither, Thomas W.; McAninch, Jack W.; McCulloch, Charles E.; Breyer, Benjamin N.

    2016-01-01

    To determine which factors are associated with higher costs of urethroplasty procedure and whether these factors have been increasing over time. Identification of determinants of extreme costs may help reduce cost while maintaining quality.We conducted a retrospective analysis using the 2001-2010 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS). The HCUP-NIS captures hospital charges which we converted to cost using the HCUP cost-to-charge ratio. Log cost linear ...

  8. Can There Ever Be Enough to Impact Water Quality? Evaluating BMPs in Elliot Ditch, Indiana Using the LTHIA-LID Model

    Science.gov (United States)

    Rahman, M. S.; Hoover, F. A.; Bowling, L. C.

    2017-12-01

    Elliot Ditch is an urban/urbanizing watershed located in the city of Lafayette, IN, USA. The city continues to struggle with stormwater management and combined sewer overflow (CSO) events. Several best-management practices (BMP) such as rain gardens, green roofs, and bioswales have been implemented in the watershed, but the level of adoption needed to achieve meaningful impact is currently unknown. This study's goal is to determine what level of BMP coverage is needed to impact water quality, whether meaningful impact is determined by achieving water quality targets or statistical significance. A power analysis was performed using water quality data for total suspended solids (TSS), E.coli, total phosphorus (TP) and nitrate (NO3-N) from Elliot Ditch from 2011 to 2015. The minimum detectable difference (MDD) was calculated as the percent reduction in load needed to detect a significant change in the watershed. The water quality targets were proposed by stakeholders as part of a watershed management planning process. The water quality targets and the MDD percentages were then compared to simulated load reductions due to BMP implementation using the Long-term Hydrologic Impact Assessment-Low Impact Development (LTHIA-LID) model. Seven baseline model scenarios were simulated by implementing the maximum number of each of six types of BMPs (rain barrels, permeable patios, green roofs, grassed swale/bioswales, bioretention/rain gardens, and porous pavement), as well as all the practices combined in the watershed. These provide the baseline for targeted implementation scenarios designed to determine if statistically and physically meaningful load reductions can be achieved through BMP implementation alone.

  9. Tuberculosis screening of travelers to higher-incidence countries: A cost-effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Menzies Dick

    2008-06-01

    Full Text Available Abstract Background Travelers to countries with high tuberculosis incidence can acquire infection during travel. We sought to compare four screening interventions for travelers from low-incidence countries, who visit countries with varying tuberculosis incidence. Methods Decision analysis model: We considered hypothetical cohorts of 1,000 travelers, 21 years old, visiting Mexico, the Dominican Republic, or Haiti for three months. Travelers departed from and returned to the United States or Canada; they were born in the United States, Canada, or the destination countries. The time horizon was 20 years, with 3% annual discounting of future costs and outcomes. The analysis was conducted from the health care system perspective. Screening involved tuberculin skin testing (post-travel in three strategies, with baseline pre-travel tests in two, or chest radiography post-travel (one strategy. Returning travelers with tuberculin conversion (one strategy or other evidence of latent tuberculosis (three strategies were offered treatment. The main outcome was cost (in 2005 US dollars per tuberculosis case prevented. Results For all travelers, a single post-trip tuberculin test was most cost-effective. The associated cost estimate per case prevented ranged from $21,406 for Haitian-born travelers to Haiti, to $161,196 for US-born travelers to Mexico. In all sensitivity analyses, the single post-trip tuberculin test remained most cost-effective. For US-born travelers to Haiti, this strategy was associated with cost savings for trips over 22 months. Screening was more cost-effective with increasing trip duration and infection risk, and less so with poorer treatment adherence. Conclusion A single post-trip tuberculin skin test was the most cost-effective strategy considered, for travelers from the United States or Canada. The analysis did not evaluate the use of interferon-gamma release assays, which would be most relevant for travelers who received BCG

  10. Combining the Power of Statistical Analyses and Community Interviews to Identify Adoption Barriers for Stormwater Best-Management Practices

    Science.gov (United States)

    Hoover, F. A.; Bowling, L. C.; Prokopy, L. S.

    2015-12-01

    Urban stormwater is an on-going management concern in municipalities of all sizes. In both combined or separated sewer systems, pollutants from stormwater runoff enter the natural waterway system during heavy rain events. Urban flooding during frequent and more intense storms are also a growing concern. Therefore, stormwater best-management practices (BMPs) are being implemented in efforts to reduce and manage stormwater pollution and overflow. The majority of BMP water quality studies focus on the small-scale, individual effects of the BMP, and the change in water quality directly from the runoff of these infrastructures. At the watershed scale, it is difficult to establish statistically whether or not these BMPs are making a difference in water quality, given that watershed scale monitoring is often costly and time consuming, relying on significant sources of funds, which a city may not have. Hence, there is a need to quantify the level of sampling needed to detect the water quality impact of BMPs at the watershed scale. In this study, a power analysis was performed on data from an urban watershed in Lafayette, Indiana, to determine the frequency of sampling required to detect a significant change in water quality measurements. Using the R platform, results indicate that detecting a significant change in watershed level water quality would require hundreds of weekly measurements, even when improvement is present. The second part of this study investigates whether the difficulty in demonstrating water quality change represents a barrier to adoption of stormwater BMPs. Semi-structured interviews of community residents and organizations in Chicago, IL are being used to investigate residents understanding of water quality and best management practices and identify their attitudes and perceptions towards stormwater BMPs. Second round interviews will examine how information on uncertainty in water quality improvements influences their BMP attitudes and perceptions.

  11. Retrofitting impervious urban infrastructure with green technology for rainfall-runoff restoration, indirect reuse and pollution load reduction

    International Nuclear Information System (INIS)

    Sansalone, John; Raje, Saurabh; Kertesz, Ruben; Maccarone, Kerrilynn; Seltzer, Karl; Siminari, Michele; Simms, Peter; Wood, Brandon

    2013-01-01

    The built environs alter hydrology and water resource chemistry. Florida is subject to nutrient criteria and is promulgating “no-net-load-increase” criteria for runoff and constituents (nutrients and particulate matter, PM). With such criteria, green infrastructure, hydrologic restoration, indirect reuse and source control are potential design solutions. The study simulates runoff and constituent load control through urban source area re-design to provide long-term “no-net-load-increases”. A long-term continuous simulation of pre- and post-development response for an existing surface parking facility is quantified. Retrofits include a biofiltration area reactor (BAR) for hydrologic and denitrification control. A linear infiltration reactor (LIR) of cementitious permeable pavement (CPP) provides infiltration, adsorption and filtration. Pavement cleaning provided source control. Simulation of climate and source area data indicates re-design achieves “no-net-load-increases” at lower costs compared to standard construction. The retrofit system yields lower cost per nutrient load treated compared to Best Management Practices (BMPs). -- Continuous simulation of climate and site data demonstrate that urban re-design using green infrastructure can provide long-term “no-net-load-increases” at a lower costs compared to BMPs

  12. Photonic Integrated Circuits for Cost-Effective, High Port Density, and Higher Capacity Optical Communications Systems

    Science.gov (United States)

    Chiappa, Pierangelo

    Bandwidth-hungry services, such as higher speed Internet, voice over IP (VoIP), and IPTV, allow people to exchange and store huge amounts of data among worldwide locations. In the age of global communications, domestic users, companies, and organizations around the world generate new contents making bandwidth needs grow exponentially, along with the need for new services. These bandwidth and connectivity demands represent a concern for operators who require innovative technologies to be ready for scaling. To respond efficiently to these demands, Alcatel-Lucent is fast moving toward photonic integration circuits technologies as the key to address best performances at the lowest "bit per second" cost. This article describes Alcatel-Lucent's contribution in strategic directions or achievements, as well as possible new developments.

  13. Reflections on Costing, Pricing and Income Measurement at UK Higher Education Institutions

    Science.gov (United States)

    Oduoza, Chike F.

    2009-01-01

    In these days of radical contraction of funding and expansion in student numbers, universities are under pressure to prioritise their resources, as well as to achieve effective costing and pricing to support judgement and decision making for funding and any external work undertaken. This study reviews costing, pricing and income measurement in…

  14. The cost of preventing undernutrition: cost, cost-efficiency and cost-effectiveness of three cash-based interventions on nutrition outcomes in Dadu, Pakistan.

    Science.gov (United States)

    Trenouth, Lani; Colbourn, Timothy; Fenn, Bridget; Pietzsch, Silke; Myatt, Mark; Puett, Chloe

    2018-07-01

    Cash-based interventions (CBIs) increasingly are being used to deliver humanitarian assistance and there is growing interest in the cost-effectiveness of cash transfers for preventing undernutrition in emergency contexts. The objectives of this study were to assess the costs, cost-efficiency and cost-effectiveness in achieving nutrition outcomes of three CBIs in southern Pakistan: a 'double cash' (DC) transfer, a 'standard cash' (SC) transfer and a 'fresh food voucher' (FFV) transfer. Cash and FFVs were provided to poor households with children aged 6-48 months for 6 months in 2015. The SC and FFV interventions provided $14 monthly and the DC provided $28 monthly. Cost data were collected via institutional accounting records, interviews, programme observation, document review and household survey. Cost-effectiveness was assessed as cost per case of wasting, stunting and disability-adjusted life year (DALY) averted. Beneficiary costs were higher for the cash groups than the voucher group. Net total cost transfer ratios (TCTRs) were estimated as 1.82 for DC, 2.82 for SC and 2.73 for FFV. Yet, despite the higher operational costs, the FFV TCTR was lower than the SC TCTR when incorporating the participation cost to households, demonstrating the relevance of including beneficiary costs in cost-efficiency estimations. The DC intervention achieved a reduction in wasting, at $4865 per case averted; neither the SC nor the FFV interventions reduced wasting. The cost per case of stunting averted was $1290 for DC, $882 for SC and $883 for FFV. The cost per DALY averted was $641 for DC, $434 for SC and $563 for FFV without discounting or age weighting. These interventions are highly cost-effective by international thresholds. While it is debatable whether these resource requirements represent a feasible or sustainable investment given low health expenditures in Pakistan, these findings may provide justification for continuing Pakistan's investment in national social safety

  15. Higher energy: is it necessary, is it worth the cost for radiation oncology?

    Science.gov (United States)

    Das, I J; Kase, K R

    1992-01-01

    The physical characteristics of the interactions of megavoltage photons and electrons with matter provide distinct advantages, relative to low-energy (orthovoltage) x rays, that lead to better radiation dose distributions in patients. Use of these high-energy radiations has resulted in better patient care, which has been reflected in improved radiation treatment outcome in recent years. But, as the desire for higher energy radiation beams increases, it becomes important to determine whether the physical characteristics that make megavoltage beams beneficial continue to provide a net advantage. It is demonstrated that, in fact, there is an energy range from 4 to 15 MV for photons and 4 to 20 MeV for electrons that is optimally suited for the treatment of cancer in humans. Radiation beams that exceed these maximum energies were found to add no advantage. This is because the costs (price of unit, installation, maintenance, shielding for neutron and photons) are not justified by either improved physical characteristics of the radiation (penetration, skin sparing, dose distribution) or treatment outcome. In fact, for photon beams some physical characteristics result in less desirable dose distributions, less accurate dosimetry, and increased safety problems as the energy increases for example, increasingly diffuse beam edges, loss of electron equilibrium, uncertainty in dose perturbations at interfaces, increased neutron contamination, and potential for higher personnel dose. The special features that make electron beams useful at lower energies, for example, skin sparing and small penetration, are lost at high energies. These physical factors are analyzed together with the economic factors related to radiation therapy patient care using megavoltage beams.

  16. Estimating the cost of referral and willingness to pay for referral to higher-level health facilities: a case series study from an integrated community case management programme in Uganda.

    Science.gov (United States)

    Nanyonjo, Agnes; Bagorogoza, Benson; Kasteng, Frida; Ayebale, Godfrey; Makumbi, Fredrick; Tomson, Göran; Källander, Karin

    2015-08-28

    Integrated community case management (iCCM) relies on community health workers (CHWs) managing children with malaria, pneumonia, diarrhoea, and referring children when management is not possible. This study sought to establish the cost per sick child referred to seek care from a higher-level health facility by a CHW and to estimate caregivers' willingness to pay (WTP) for referral. Caregivers of 203 randomly selected children referred to higher-level health facilities by CHWs were interviewed in four Midwestern Uganda districts. Questionnaires and document reviews were used to capture direct, indirect and opportunity costs incurred by caregivers, CHWs and health facilities managing referred children. WTP for referral was assessed through the 'bidding game' approach followed by an open-ended question on maximum WTP. Descriptive analysis was conducted for factors associated with referral completion and WTP using logistic and linear regression methods, respectively. The cost per case referred to higher-level health facilities was computed from a societal perspective. Reasons for referral included having fever with a negative malaria test (46.8%), danger signs (29.6%) and drug shortage (37.4%). Among the referred, less than half completed referral (45.8%). Referral completion was 2.8 times higher among children with danger signs (p = 0.004) relative to those without danger signs, and 0.27 times lower among children who received pre-referral treatment (p average cost per case referred was US$ 4.89 and US$7.35 per case completing referral. For each unit cost per case referred, caregiver out of pocket expenditure contributed 33.7%, caregivers' and CHWs' opportunity costs contributed 29.2% and 5.1% respectively and health facility costs contributed 39.6%. The mean (SD) out of pocket expenditure was US$1.65 (3.25). The mean WTP for referral was US$8.25 (14.70) and was positively associated with having received pre-referral treatment, completing referral and increasing

  17. Cost benefit analysis vs. referenda

    OpenAIRE

    Martin J. Osborne; Matthew A. Turner

    2007-01-01

    We consider a planner who chooses between two possible public policies and ask whether a referendum or a cost benefit analysis leads to higher welfare. We find that a referendum leads to higher welfare than a cost benefit analyses in "common value" environments. Cost benefit analysis is better in "private value" environments.

  18. The Economics of Mitigation of Water Pollution Externalities from Biomass Production for Energy

    Directory of Open Access Journals (Sweden)

    Naveen Adusumilli

    2014-12-01

    Full Text Available To fulfill the national bioenergy goals of the United States, conversion of marginal lands to intensive biomass crop production and/or application of greater amounts of nutrients to existing cropland could be expected. Such change in agricultural practices could produce unintended environmental consequences such as water quality degradation. Select Best Management Practices (BMPs are evaluated for water quality mitigation effectiveness as well as for their relative cost-effectiveness, issues that are often ignored in evaluation of biofuels as a sustainable solution for energy demand. The water quality impacts of converting pastureland to intensive biomass production for biofuel, evaluated using the Soil Water Assessment Tool (SWAT, indicate significant increases in erosion and nutrient loadings to water bodies. Hydrologic and economic evaluation of the BMPs indicate their implementation produced effective water pollution mitigation but at substantial costs, accentuating the sustainability issue related to the economics of renewable fuels. U.S. national energy policy designed around achieving energy independence should also consider environmental and economic trade-offs for biofuels to be an economically and environmentally sustainable alternative to fossil fuels.

  19. Forestry Best Management Practices Relationships with Aquatic and Riparian Fauna: A Review

    Directory of Open Access Journals (Sweden)

    Brooke M. Warrington

    2017-09-01

    Full Text Available Forestry best management practices (BMPs were developed to minimize water pollution from forestry operations by primarily addressing sediment and sediment transport, which is the leading source of pollution from silviculture. Implementation of water quality BMPs may also benefit riparian and aquatic wildlife, although wildlife benefits were not driving forces for BMP development. Therefore, we reviewed literature regarding potential contributions of sediment-reducing BMPs to conservation of riparian and aquatic wildlife, while realizing that BMPs also minimize thermal, nutrient, and chemical pollution. We reached five important conclusions: (1 a significant body of research confirms that forestry BMPs contribute to the protection of water quality and riparian forest structure; (2 data-specific relationships between forestry BMPs and reviewed species are limited; (3 forestry BMPs for forest road construction and maintenance, skid trails, stream crossings, and streamside management zones (SMZs are important particularly for protection of water quality and aquatic species; (4 stream crossings should be carefully selected and installed to minimize sediment inputs and stream channel alterations; and (5 SMZs promote retention of older-age riparian habitat with benefits extending from water bodies to surrounding uplands. Overall, BMPs developed for protection of water quality should benefit a variety of riparian and aquatic species that are sensitive to changes in water quality or forest structure.

  20. Forestry best management practices relationships with aquatic and riparian fauna: A review

    Science.gov (United States)

    Warrington, Brooke M.; Aust, W. Michael; Barrett, Scott M.; Ford, W. Mark; Dolloff, C. Andrew; Schilling, Erik B.; Wigley, T. Bently; Bolding, M. Chad

    2017-01-01

    Forestry best management practices (BMPs) were developed to minimize water pollution from forestry operations by primarily addressing sediment and sediment transport, which is the leading source of pollution from silviculture. Implementation of water quality BMPs may also benefit riparian and aquatic wildlife, although wildlife benefits were not driving forces for BMP development. Therefore, we reviewed literature regarding potential contributions of sediment-reducing BMPs to conservation of riparian and aquatic wildlife, while realizing that BMPs also minimize thermal, nutrient, and chemical pollution. We reached five important conclusions: (1) a significant body of research confirms that forestry BMPs contribute to the protection of water quality and riparian forest structure; (2) data-specific relationships between forestry BMPs and reviewed species are limited; (3) forestry BMPs for forest road construction and maintenance, skid trails, stream crossings, and streamside management zones (SMZs) are important particularly for protection of water quality and aquatic species; (4) stream crossings should be carefully selected and installed to minimize sediment inputs and stream channel alterations; and (5) SMZs promote retention of older-age riparian habitat with benefits extending from water bodies to surrounding uplands. Overall, BMPs developed for protection of water quality should benefit a variety of riparian and aquatic species that are sensitive to changes in water quality or forest structure.

  1. Cost and cost-effectiveness of conventional and liquid-based ...

    African Journals Online (AJOL)

    Methods. The unit of effectiveness was defined as the number of cervical intraepithelial neoplasm (CIN) II or higher lesions detected. Costs were assessed retrospectively for the financial year (2010/11) from a laboratory service provider perspective. A cost-effectiveness analysis was performed by combining secondary data ...

  2. Meeting UK dietary recommendations is associated with higher estimated consumer food costs: an analysis using the National Diet and Nutrition Survey and consumer expenditure data, 2008-2012.

    Science.gov (United States)

    Jones, Nicholas Rv; Tong, Tammy Yn; Monsivais, Pablo

    2018-04-01

    To test whether diets achieving recommendations from the UK's Scientific Advisory Committee on Nutrition (SACN) were associated with higher monetary costs in a nationally representative sample of UK adults. A cross-sectional study linking 4 d diet diaries in the National Diet and Nutrition Survey (NDNS) to contemporaneous food price data from a market research firm. The monetary cost of diets was assessed in relation to whether or not they met eight food- and nutrient-based recommendations from SACN. Regression models adjusted for potential confounding factors. The primary outcome measure was individual dietary cost per day and per 2000 kcal (8368 kJ). UK. Adults (n 2045) sampled between 2008 and 2012 in the NDNS. On an isoenergetic basis, diets that met the recommendations for fruit and vegetables, oily fish, non-milk extrinsic sugars, fat, saturated fat and salt were estimated to be between 3 and 17 % more expensive. Diets meeting the recommendation for red and processed meats were 4 % less expensive, while meeting the recommendation for fibre was cost-neutral. Meeting multiple targets was also associated with higher costs; on average, diets meeting six or more SACN recommendations were estimated to be 29 % more costly than isoenergetic diets that met no recommendations. Food costs may be a population-level barrier limiting the adoption of dietary recommendations in the UK. Future research should focus on identifying systems- and individual-level strategies to enable consumers achieve dietary recommendations without increasing food costs. Such strategies may improve the uptake of healthy eating in the population.

  3. Strategies for delivering bone morphogenetic protein for bone healing

    Energy Technology Data Exchange (ETDEWEB)

    Begam, Howa [School of Bioscience and Engineering, Jadavpur University, Kolkata 700032 (India); Nandi, Samit Kumar, E-mail: samitnandi1967@gmail.com [Department of Veterinary Surgery, Radiology West Bengal University of Animal and Fishery Sciences, Kolkata 700037 (India); Kundu, Biswanath, E-mail: biswa_kundu@rediffmail.com [Bioceramics and Coating Division, CSIR-Central Glass and Ceramic Research Institute, Kolkata 700032 (India); Chanda, Abhijit [Department of Mechanical Engineering, Jadavpur University, Kolkata 700032 (India)

    2017-01-01

    Bone morphogenetic proteins (BMPs) are the most significant growth factors that belong to the Transforming Growth Factor Beta (TGF-β) super-family. Though more than twenty members of this family have been identified so far in humans, Food and Drug Administration (FDA) approved two growth factors: BMP-2 and BMP-7 for treatments of spinal fusion and long-bone fractures with collagen carriers. Currently BMPs are clinically used in spinal fusion, oral and maxillofacial surgery and also in the repair of long bone defects. The efficiency of BMPs depends a lot on the selection of suitable carriers. At present, different types of carrier materials are used: natural and synthetic polymers, calcium phosphate and ceramic-polymer composite materials. Number of research articles has been published on the minute intricacies of the loading process and release kinetics of BMPs. Despite the significant evidence of its potential for bone healing demonstrated in animal models, future clinical investigations are needed to define dose, scaffold and route of administration. The efficacy and application of BMPs in various levels with a proper carrier and dose is yet to be established. The present article collates various aspects of success and limitation and identifies the prospects and challenges associated with the use of BMPs in orthopaedic surgery. - Highlights: • Currently BMPs are clinically used in spinal fusion, oral and maxillofacial surgery and also in repair of long bone defects. • Different types of carrier materials are used: natural, synthetic polymers, calcium phosphate and ceramic-polymer composite • Efficacy and application of BMPs in various levels with proper carrier and dose is yet to be established • Number of research articles has been published on minute intricacies of loading process and release kinetics of BMPs • Present article collates success, limitation and identifies prospects, challenges for use of BMPs in orthopaedic surgery.

  4. Can Online Learning Bend the Higher Education Cost Curve?

    OpenAIRE

    David J. Deming; Claudia Goldin; Lawrence F. Katz; Noam Yuchtman

    2015-01-01

    We examine whether online learning technologies have led to lower prices in higher education. Using data from the Integrated Postsecondary Education Data System, we show that online education is concentrated in large for-profit chains and less-selective public institutions. We find that colleges with a higher share of online students charge lower tuition prices. We present evidence of declining real and relative prices for full-time undergraduate online education from 2006 to 2013. Although t...

  5. Controlling Health Care Costs

    Science.gov (United States)

    Dessoff, Alan

    2009-01-01

    This article examines issues on health care costs and describes measures taken by public districts to reduce spending. As in most companies in America, health plan designs in public districts are being changed to reflect higher out-of-pocket costs, such as higher deductibles on visits to providers, hospital stays, and prescription drugs. District…

  6. Replacement power costs due to nuclear-plant outages: a higher standard of care

    International Nuclear Information System (INIS)

    Gransee, M.F.

    1982-01-01

    This article examines recent state public utility commission cases that deal with the high costs of replacement power that utilities must purchase after a nuclear power plant outage. Although most commissions have approved such expenses, it may be that there is a trend toward splitting the costs of such expenses between ratepayer and stockholder. Commissions are demanding a management prudence test to determine the cause of the outage and whether it meets the reasonable man standard before allowing these costs to be passed along to ratepayers. Unless the standard is applied with flexibility, however, utility companies could invoke the defenses covering traditional common law negligence

  7. Does obesity along with major depression or anxiety lead to higher use of health care and costs? : A 6-year follow-up study

    NARCIS (Netherlands)

    Nigatu, Yeshambel T.; Bultmann, Ute; Schoevers, Robert A.; Penninx, Brenda W. J. H.; Reijneveld, Sijmen A.

    2017-01-01

    Background: Evidence lacks on whether obesity along with major depression (MD)/anxiety leads to higher health care use (HCU) and health care-related costs (HCC) compared with either condition alone. The objective of the study was to examine the longitudinal associations of obesity, MD/anxiety, and

  8. Intravenous thrombolysis of large vessel occlusions is associated with higher hospital costs than small vessel strokes: a rationale for developing stroke severity-based financial models.

    Science.gov (United States)

    Rai, Ansaar T; Evans, Kim; Riggs, Jack E; Hobbs, Gerald R

    2016-04-01

    Owing to their severity, large vessel occlusion (LVO) strokes may be associated with higher costs that are not reflected in current coding systems. This study aimed to determine whether intravenous thrombolysis costs are related to the presence or absence of LVO. Patients who had undergone intravenous thrombolysis over a 9-year period were divided into LVO and no LVO (nLVO) groups based on admission CT angiography. The primary outcome was hospital cost per admission. Secondary outcomes included admission duration, 90-day clinical outcome, and discharge destination. 119 patients (53%) had LVO and 104 (47%) had nLVO. Total mean±SD cost per LVO patient was $18,815±14,262 compared with $15,174±11,769 per nLVO patient (p=0.04). Hospital payments per admission were $17,338±13,947 and $15,594±16,437 for LVO and nLVO patients, respectively (p=0.4). A good outcome was seen in 33 LVO patients (27.7%) and in 69 nLVO patients (66.4%) (OR 0.2, 95% CI 0.1 to 0.3, pregression analysis after controlling for comorbidities showed the presence of LVO to be an independent predictor of higher total hospital costs. The presence or absence of LVO is associated with significant differences in hospital costs, outcomes, admission duration, and home discharge. These differences can be important when developing systems of care models for acute ischemic stroke. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Internationalization of Higher Education: Potential Benefits and Costs

    Science.gov (United States)

    Jibeen, Tahira; Khan, Masha Asad

    2015-01-01

    Internationalization of higher education is the top stage of international relations among universities and it is no longer regarded as a goal in itself, but as a means to improve the quality of education. The knowledge translation and acquisition, mobilization of talent in support of global research and enchantment of the curriculum with…

  10. Fibroblast growth factor 2 inhibits up-regulation of bone morphogenic proteins and their receptors during osteoblastic differentiation of human mesenchymal stem cells

    Energy Technology Data Exchange (ETDEWEB)

    Biver, Emmanuel, E-mail: ebiver@yahoo.fr [Physiopathology of Inflammatory Bone Diseases, EA 4490, University Lille North of France, Quai Masset, Bassin Napoleon, BP120, 62327 Boulogne sur Mer (France); Department of Rheumatology, Lille University Hospital, Roger Salengro Hospital, 59037 Lille cedex (France); Service of Bone Diseases, Department of Internal Medicine Specialties, University Hospital of Geneva, CH-1211 Geneva 14 (Switzerland); Soubrier, Anne-Sophie [Physiopathology of Inflammatory Bone Diseases, EA 4490, University Lille North of France, Quai Masset, Bassin Napoleon, BP120, 62327 Boulogne sur Mer (France); Department of Rheumatology, Lille University Hospital, Roger Salengro Hospital, 59037 Lille cedex (France); Thouverey, Cyril [Service of Bone Diseases, Department of Internal Medicine Specialties, University Hospital of Geneva, CH-1211 Geneva 14 (Switzerland); Cortet, Bernard [Physiopathology of Inflammatory Bone Diseases, EA 4490, University Lille North of France, Quai Masset, Bassin Napoleon, BP120, 62327 Boulogne sur Mer (France); Department of Rheumatology, Lille University Hospital, Roger Salengro Hospital, 59037 Lille cedex (France); Broux, Odile [Physiopathology of Inflammatory Bone Diseases, EA 4490, University Lille North of France, Quai Masset, Bassin Napoleon, BP120, 62327 Boulogne sur Mer (France); Caverzasio, Joseph [Service of Bone Diseases, Department of Internal Medicine Specialties, University Hospital of Geneva, CH-1211 Geneva 14 (Switzerland); Hardouin, Pierre [Physiopathology of Inflammatory Bone Diseases, EA 4490, University Lille North of France, Quai Masset, Bassin Napoleon, BP120, 62327 Boulogne sur Mer (France)

    2012-11-02

    Highlights: Black-Right-Pointing-Pointer FGF modulates BMPs pathway in HMSCs by down-regulating BMP/BMPR expression. Black-Right-Pointing-Pointer This effect is mediated by ERK and JNK MAPKs pathways. Black-Right-Pointing-Pointer Crosstalk between FGF and BMPs must be taken into account in skeletal bioengineering. Black-Right-Pointing-Pointer It must also be considered in the use of recombinant BMPs in orthopedic and spine surgeries. -- Abstract: Understanding the interactions between growth factors and bone morphogenic proteins (BMPs) signaling remains a crucial issue to optimize the use of human mesenchymal stem cells (HMSCs) and BMPs in therapeutic perspectives and bone tissue engineering. BMPs are potent inducers of osteoblastic differentiation. They exert their actions via BMP receptors (BMPR), including BMPR1A, BMPR1B and BMPR2. Fibroblast growth factor 2 (FGF2) is expressed by cells of the osteoblastic lineage, increases their proliferation and is secreted during the healing process of fractures or in surgery bone sites. We hypothesized that FGF2 might influence HMSC osteoblastic differentiation by modulating expressions of BMPs and their receptors. BMP2, BMP4, BMPR1A and mainly BMPR1B expressions were up-regulated during this differentiation. FGF2 inhibited HMSCs osteoblastic differentiation and the up-regulation of BMPs and BMPR. This effect was prevented by inhibiting the ERK or JNK mitogen-activated protein kinases which are known to be activated by FGF2. These data provide a mechanism explaining the inhibitory effect of FGF2 on osteoblastic differentiation of HMSCs. These crosstalks between growth and osteogenic factors should be considered in the use of recombinant BMPs in therapeutic purpose of fracture repair or skeletal bioengineering.

  11. A model for evaluating the institutional costs and benefits of ICT initiatives in teaching and learning in higher education

    Directory of Open Access Journals (Sweden)

    David Nicol

    2003-12-01

    Full Text Available Significant investments are being made in the application of new information and communications technologies (ICT to teaching and learning in higher education. However, until recently, there has been little progress in devising an integrated costbenefit model that decision-makers can use to appraise ICT investment options from the wider institutional perspective. This paper describes and illustrates a model that has been developed to enable evaluations of the costs and benefits of the use of ICT. The strengths and limitations of the model are highlighted and discussed

  12. Effectiveness of best management practices that have application to forest roads: a literature synthesis

    Science.gov (United States)

    Pamela J. Edwards; Frederica Wood; Robin L. Quinlivan

    2016-01-01

    Literature describing the effectiveness of best management practices (BMPs) applicable to forest roads is reviewed and synthesized. Effectiveness is considered from the perspective of protecting water quality and water resources. Both paved and unpaved forest roads are considered, but BMPs that involve substantial engineering are not considered. Some of the BMPs...

  13. Marketing Policy and Its Cost in a College of Higher Education.

    Science.gov (United States)

    Riley, Eric

    1984-01-01

    Discusses the development of advertising and publicity strategies and policy for student recruitment purposes at a college of education in the United Kingdom between 1972 and 1982. Covers changes in staff attitudes, selection of media, organization of administration, and cost factors. (PGD)

  14. The weighted average cost of capital over the lifecycle of the firm: Is the overinvestment problem of mature firms intensified by a higher WACC?

    Directory of Open Access Journals (Sweden)

    Carlos S. Garcia

    2016-08-01

    Full Text Available Firm lifecycle theory predicts that the Weighted Average Cost of Capital (WACC will tend to fall over the lifecycle of the firm (Mueller, 2003, p. 80-81. However, given that previous research finds that corporate governance deteriorates as firms get older (Mueller and Yun, 1998; Saravia, 2014 there is good reason to suspect that the opposite could be the case, that is, that the WACC is higher for older firms. Since our literature review indicates that no direct tests to clarify this question have been carried out up till now, this paper aims to fill the gap by testing this prediction empirically. Our findings support the proposition that the WACC of younger firms is higher than that of mature firms. Thus, we find that the mature firm overinvestment problem is not intensified by a higher cost of capital, on the contrary, our results suggest that mature firms manage to invest in negative net present value projects even though they have access to cheaper capital. This finding sheds new light on the magnitude of the corporate governance problems found in mature firms.

  15. Bone morphogenetic proteins in inflammation, glucose homeostasis and adipose tissue energy metabolism

    DEFF Research Database (Denmark)

    Grgurevic, Lovorka; Christensen, Gitte Lund; Schulz, Tim J

    2016-01-01

    implicated in pancreas development as well as control of adult glucose homeostasis. Lastly, we review the recently recognized role of BMPs in brown adipose tissue formation and their consequences for energy expenditure and adiposity. In summary, BMPs play a pivotal role in metabolism beyond their role...... homeostasis (anaemia, hemochromatosis) and oxidative damage. The second and third parts of this review focus on BMPs in the development of metabolic pathologies such as type-2 diabetes mellitus and obesity. The pancreatic beta cells are the sole source of the hormone insulin and BMPs have recently been...

  16. The Real University Cost in a ''Free'' Higher Education Country

    Science.gov (United States)

    Psacharopoulos, G.; Papakonstantinou, G.

    2005-01-01

    Using a sample of over 3000 first year university entrants in Greece, we investigate the time and expense incurred in preparation for the highly competitive higher education entry examinations, as well as what students spend privately while attending university. It is shown that in a constitutionally ''free for all'' higher education country,…

  17. Financial Resource Allocation in Higher Education

    Science.gov (United States)

    Ušpuriene, Ana; Sakalauskas, Leonidas; Dumskis, Valerijonas

    2017-01-01

    The paper considers a problem of financial resource allocation in a higher education institution. The basic financial management instruments and the multi-stage cost minimization model created are described involving financial instruments to constraints. Both societal and institutional factors that determine the costs of educating students are…

  18. The disarmament cost

    International Nuclear Information System (INIS)

    Cattaneo, M.

    1996-01-01

    War is costly. But peace cost is even higher. The destruction of weapons (mines, nuclear weapons, chemical weapons) is much more expensive than their manufacturing. The soldiers demobilization cost is enormous, for instance in Angola, Mozambique, Nicaragua, Zimbabwe the demobilization of 270000 soldiers cost 2.5 10 9 francs. The measures intended to reduce the war risk are also expensive. That is why the arsenal of ex USSR is still intact. Today no international agency is entirely dedicated to peace building. The question is how would cost such an agency? (O.L.). 5 refs., 2 figs

  19. 34 CFR 74.27 - Allowable costs.

    Science.gov (United States)

    2010-07-01

    ... Procedures or uniform cost accounting standards that comply with cost principles acceptable to ED. (b) The... OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial... principles for determining allowable costs. Allowability of costs are determined in accordance with the cost...

  20. Higher fees paid to US physicians drive higher spending for physician services compared to other countries.

    Science.gov (United States)

    Laugesen, Miriam J; Glied, Sherry A

    2011-09-01

    Higher health care prices in the United States are a key reason that the nation's health spending is so much higher than that of other countries. Our study compared physicians' fees paid by public and private payers for primary care office visits and hip replacements in Australia, Canada, France, Germany, the United Kingdom, and the United States. We also compared physicians' incomes net of practice expenses, differences in financing the cost of medical education, and the relative contribution of payments per physician and of physician supply in the countries' national spending on physician services. Public and private payers paid somewhat higher fees to US primary care physicians for office visits (27 percent more for public, 70 percent more for private) and much higher fees to orthopedic physicians for hip replacements (70 percent more for public, 120 percent more for private) than public and private payers paid these physicians' counterparts in other countries. US primary care and orthopedic physicians also earned higher incomes ($186,582 and $442,450, respectively) than their foreign counterparts. We conclude that the higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, were the main drivers of higher US spending, particularly in orthopedics.

  1. 28 CFR 70.27 - Allowable costs.

    Science.gov (United States)

    2010-07-01

    ... AND AGREEMENTS (INCLUDING SUBAWARDS) WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 70.27 Allowable costs. (a... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

  2. 29 CFR 95.27 - Allowable costs.

    Science.gov (United States)

    2010-07-01

    ... cost principles applicable to the entity incurring the costs. Thus, allowability of costs incurred by... Governments.” The allowability of costs incurred by non-profit organizations is determined in accordance with... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

  3. 24 CFR 84.27 - Allowable costs.

    Science.gov (United States)

    2010-04-01

    ... to the entity incurring the costs. Thus, allowability of costs incurred by State, local or federally..., “Cost Principles for State and Local Governments.” The allowability of costs incurred by non-profit...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

  4. Costs of hospital malnutrition.

    Science.gov (United States)

    Curtis, Lori Jane; Bernier, Paule; Jeejeebhoy, Khursheed; Allard, Johane; Duerksen, Donald; Gramlich, Leah; Laporte, Manon; Keller, Heather H

    2017-10-01

    Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data. To our knowledge, the last two goals have not been studied elsewhere. Univariate and multivariate analyses were performed on data from the Canadian Malnutrition Task Force prospective cohort study combined with administrative data from the Canadian Institute for Health Information. Subjective Global Assessment was used to assess the relationship between nutritional status and length of stay and hospital costs, controlling for health and demographic characteristics, for 956 patients admitted to medical and surgical wards in 18 hospitals across Canada. After controlling for patient and hospital characteristics, moderately malnourished patients' (34% of surveyed patients) hospital stays were 18% (p = 0.014) longer on average than well-nourished patients. Medical stays increased by 23% (p = 0.014), and surgical stays by 32% (p = 0.015). Costs were, on average, between 31% and 34% (p-values < 0.05) higher than for well-nourished patients with similar characteristics. Severely malnourished patients (11% of surveyed patients) stayed 34% (p = 0.000) longer and had 38% (p = 0.003) higher total costs than well-nourished patients. They stayed 53% (p = 0.001) longer in medical beds and had 55% (p = 0.003) higher medical costs, on average. Trends were similar no matter the type of costing data used. Over 40% of patients were found to be malnourished (1/3 moderately and 1/10 severely). Malnourished patients had longer hospital stays and as a result cost more than well

  5. Can value-based insurance impose societal costs?

    Science.gov (United States)

    Koenig, Lane; Dall, Timothy M; Ruiz, David; Saavoss, Josh; Tongue, John

    2014-09-01

    Among policy alternatives considered to reduce health care costs and improve outcomes, value-based insurance design (VBID) has emerged as a promising option. Most applications of VBID, however, have not used higher cost sharing to discourage specific services. In April 2011, the state of Oregon introduced a policy for public employees that required additional cost sharing for high-cost procedures such as total knee arthroplasty (TKA). Our objectives were to estimate the societal impact of higher co-pays for TKA using Oregon as a case study and building on recent work demonstrating the effects of knee osteoarthritis and surgical treatment on employment and disability outcomes. We used a Markov model to estimate the societal impact in terms of quality of life, direct costs, and indirect costs of higher co-pays for TKA using Oregon as a case study. We found that TKA for a working population can generate societal benefits that offset the direct medical costs of the procedure. Delay in receiving surgical care, because of higher co-payment or other reasons, reduced the societal savings from TKA. We conclude that payers moving toward value-based cost sharing should consider consequences beyond direct medical expenses. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  6. 45 CFR 2543.27 - Allowable costs.

    Science.gov (United States)

    2010-10-01

    ... GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 2543.27 Allowable costs. For each kind... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

  7. 20 CFR 435.27 - Allowable costs.

    Science.gov (United States)

    2010-04-01

    ... AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 435.27 Allowable costs. For each kind... Organizations.” (c) Allowability of costs incurred by institutions of higher education is determined in...

  8. 7 CFR 550.25 - Allowable costs.

    Science.gov (United States)

    2010-01-01

    ... cost principles applicable to the entity incurring the costs. Thus, allowability of costs incurred by... at 2 CFR part 225. The allowability of costs incurred by non-profit organizations is determined in... at 2 CFR part 230. The allowability of costs incurred by institutions of higher education is...

  9. Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Selected Malaysian Adults

    OpenAIRE

    Ibnteesam Pondor; Wan Ying Gan; Geeta Appannah

    2017-01-01

    Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC) in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ) and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI). DDC in Malaysian Ringgit (RM) was calculated from dietary intake and nationa...

  10. 15 CFR 14.27 - Allowable costs.

    Science.gov (United States)

    2010-01-01

    ... GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 14.27 Allowable costs. For each kind of... Organizations.” The allowability of costs incurred by institutions of higher education is determined in...

  11. 49 CFR 19.27 - Allowable costs.

    Science.gov (United States)

    2010-10-01

    ... applicable to the entity incurring the costs. Thus, allowability of costs incurred by State, local or... Circular A-87, “Cost Principles for State and Local Governments.” The allowability of costs incurred by non... Principles for Non-Profit Organizations.” The allowability of costs incurred by institutions of higher...

  12. 36 CFR 1210.27 - Allowable costs.

    Science.gov (United States)

    2010-07-01

    ... applicable to the entity incurring the costs. Thus, allowability of costs incurred by State, local or... Circular A-87, “Cost Principles for State and Local Governments.” The allowability of costs incurred by non... Principles for Non-Profit Organizations.” The allowability of costs incurred by institutions of higher...

  13. 7 CFR 3019.27 - Allowable costs.

    Science.gov (United States)

    2010-01-01

    ... applicable to the entity incurring the costs. Thus, allowability of costs incurred by State, local or... Circular A-87, “Cost Principles for State and Local Governments.” The allowability of costs incurred by non... Principles for Non-Profit Organizations.” The allowability of costs incurred by institutions of higher...

  14. Shared Leadership Transforms Higher Education IT

    Science.gov (United States)

    Duin, Ann Hill; Cawley, Steve; Gulachek, Bernard; O'Sullivan, Douglas M.; Wollner, Diane

    2011-01-01

    Globalization, immersive research and learning environments, unlimited access to information and analytics, and fiscal realities continue to impact higher education--and higher education IT. Although IT organizations face immense pressure to meet significantly greater expectations at significantly less cost, with such pressure comes the…

  15. Measuring Direct Teaching Costs: Does an Undergraduate Business Degree Cost More to Produce than a Nonbusiness Degree?

    Science.gov (United States)

    Barth, Michael M.; Karagiannidis, Iordanis

    2016-01-01

    Many universities have implemented tuition differentials for certain undergraduate degree programs, citing higher degree costs or higher demand. However, most college accounting systems are unsuited for measuring cost differentials by degree program. This research outlines a method that can convert commonly available financial data to a more…

  16. Costs comparison of electric energy in Brazil

    International Nuclear Information System (INIS)

    Goncalves, D.; Menegassi, J.

    1981-01-01

    A cost comparison study of various sources of electric energy generation was performed using uniform analysis criteria. The results indicate higher costs for coal, followed by nuclear and hidro. It was verified that presently, large hidro-power plants can only be located far from the load centers, with increasing costs of hidro-power energy in Brazil. These costs become higher than the nuclear plant if the hidro plant is located at distances exceeding 1000 Km. (Author) [pt

  17. Effects of housing system on the costs of commercial egg production.

    Science.gov (United States)

    Matthews, W A; Sumner, D A

    2015-03-01

    This article reports the first publicly available egg production costs compared across 3 hen-housing systems. We collected detailed data from 2 flock cycles from a commercial egg farm operating a conventional barn, an aviary, and an enriched colony system at the same location. The farm employed the same operational and accounting procedures for each housing system. Results provide clear evidence that egg production costs are much higher for the aviary system than the other 2 housing systems. Feed costs per dozen eggs are somewhat higher for the aviary and lower for the enriched house compared with the conventional house. Labor costs are much lower for the conventional house than the other 2, and pullet costs are much higher for the aviary. Energy and miscellaneous costs are a minimal part of total operating costs and do not differ by housing system. Total capital investments per hen-capacity are much higher for the aviary and the enriched house. Capital costs per dozen eggs depend on assumptions about appropriate interest and depreciation rates. Using the same 10% rate for each housing system shows capital costs per dozen for the aviary and the enriched housing system are much higher than capital costs per dozen for the conventional house. The aviary has average operating costs (feed, labor, pullet, energy, and miscellaneous costs that recur for each flock and vary with egg production) about 23% higher and average total costs about 36% higher compared with the conventional house. The enriched housing system has average operating costs only about 4% higher compared with the conventional house, but average total costs are 13% higher than for the conventional house. © The Author 2015. Published by Oxford University Press on behalf of Poultry Science Association.

  18. A Web-Based Model to Estimate the Impact of Best Management Practices

    Directory of Open Access Journals (Sweden)

    Youn Shik Park

    2014-03-01

    Full Text Available The Spreadsheet Tool for the Estimation of Pollutant Load (STEPL can be used for Total Maximum Daily Load (TMDL processes, since the model is capable of simulating the impacts of various best management practices (BMPs and low impact development (LID practices. The model computes average annual direct runoff using the Soil Conservation Service Curve Number (SCS-CN method with average rainfall per event, which is not a typical use of the SCS-CN method. Five SCS-CN-based approaches to compute average annual direct runoff were investigated to explore estimated differences in average annual direct runoff computations using daily precipitation data collected from the National Climate Data Center and generated by the CLIGEN model for twelve stations in Indiana. Compared to the average annual direct runoff computed for the typical use of the SCS-CN method, the approaches to estimate average annual direct runoff within EPA STEPL showed large differences. A web-based model (STEPL WEB was developed with a corrected approach to estimate average annual direct runoff. Moreover, the model was integrated with the Web-based Load Duration Curve Tool, which identifies the least cost BMPs for each land use and optimizes BMP selection to identify the most cost-effective BMP implementations. The integrated tools provide an easy to use approach for performing TMDL analysis and identifying cost-effective approaches for controlling nonpoint source pollution.

  19. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons.

    Directory of Open Access Journals (Sweden)

    Julia K Ostermann

    Full Text Available The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group with the costs for those receiving usual care (control group.Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache.Data from 44,550 patients (67.3% females were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14-7,414.29] than in the control group (EUR 5,857.56 [5,650.98-6,064.13]; p<0.0001 with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48-3,809.53] vs. control EUR 3,092.84 [2,981.31-3,204.37] and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90-1,102.59] vs. control EUR 867.87 [853.52-882.21]. Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant.Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system.

  20. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons

    Science.gov (United States)

    Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M.

    2015-01-01

    Objectives The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group) with the costs for those receiving usual care (control group). Methods Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome) and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs) across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache). Results Data from 44,550 patients (67.3% females) were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14–7,414.29]) than in the control group (EUR 5,857.56 [5,650.98–6,064.13]; phomeopathy EUR 3,698.00 [3,586.48–3,809.53] vs. control EUR 3,092.84 [2,981.31–3,204.37]) and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90–1,102.59] vs. control EUR 867.87 [853.52–882.21]). Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant. Conclusion Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system. PMID:26230412

  1. Is Higher Education Economically Unsustainable? An Exploration of Factors That Undermine Sustainability Assessments of Higher Education

    Science.gov (United States)

    Maragakis, Antonios; van den Dobbelsteen, Andy; Maragakis, Alexandros

    2016-01-01

    As students continue to review the sustainability of higher education institutions, there is a growing need to understand the economic returns of degrees as a function of a sustainable institution. This paper reviews a range of international research to summarize the economic drivers of higher education attainment. Although the cost inputs to…

  2. Strategies for compensating for higher costs of geothermal electricity with environmental benefits

    International Nuclear Information System (INIS)

    Murphy, H.; Niitsuma, Hiroaki

    1999-01-01

    After very high growth in the 1980s, geothermal electricity production has slowed in the mid- and late-1990s. While Japanese, Indonesian and Philippine geothermal growth has remained high as a consequence of supportive government policies, geothermal electricity production has been flat or reduced in much of Europe and North America. Low prices for coal and natural gas, combined with deregulation, means that in much of the world electricity from new fuel-burning electricity plants can be provided at half the cost of new geothermal electricity. Cost-cutting must be pursued, but is unlikely to close the price gap by itself. Geothermal production is widely perceived as being environmentally clean, but this is not unambiguously true, and requires reinjection to be fully realized. Strategies for monetizing the environmental advantages of geothermal, including the carbon tax, are discussed. (author)

  3. Technology and the Broken Higher Education Cost Model: Insights from the Delta Cost Project

    Science.gov (United States)

    Kirshstein, Rita; Wellman, Jane

    2012-01-01

    Although U.S. higher education has faced numerous crises and dilemmas in its history, the situation in which colleges and universities find themselves at the moment is indeed different. Shrinking public subsidies coupled with historic rises in tuitions come at the same time that colleges and universities have been tasked to dramatically increase…

  4. Putting people into water quality modelling.

    Science.gov (United States)

    Strickert, G. E.; Hassanzadeh, E.; Noble, B.; Baulch, H. M.; Morales-Marin, L. A.; Lindenschmidt, K. E.

    2017-12-01

    Water quality in the Qu'Appelle River Basin, Saskatchewan is under pressure due to nutrient pollution entering the river system from major cities, industrial zones and agricultural areas. Among these stressors, agricultural activities are basin-wide; therefore, they are the largest non-point source of water pollution in this region. The dynamics of agricultural impacts on water quality are complex and stem from decisions and activities of two distinct stakeholder groups, namely grain farmers and cattle producers, which have different business plans, values, and attitudes towards water quality. As a result, improving water quality in this basin requires engaging with stakeholders to: (1) understand their perspectives regarding a range of agricultural Beneficial Management Practices (BMPs) that can improve water quality in the region, (2) show them the potential consequences of their selected BMPs, and (3) work with stakeholders to better understand the barriers and incentives to implement the effective BMPs. In this line, we held a series of workshops in the Qu'Appelle River Basin with both groups of stakeholders to understand stakeholders' viewpoints about alternative agricultural BMPs and their impact on water quality. Workshop participants were involved in the statement sorting activity (Q-sorts), group discussions, as well as mapping activity. The workshop outcomes show that stakeholder had four distinct viewpoints about the BMPs that can improve water quality, i.e., flow and erosion control, fertilizer management, cattle site management, as well as mixed cattle and wetland management. Accordingly, to simulate the consequences of stakeholder selected BMPs, a conceptual water quality model was developed using System Dynamics (SD). The model estimates potential changes in water quality at the farm, tributary and regional scale in the Qu'Appelle River Basin under each and/or combination of stakeholder selected BMPs. The SD model was then used for real

  5. High-cost users of medical care

    OpenAIRE

    Garfinkel, Steven A.; Riley, Gerald F.; Iannacchione, Vincent G.

    1988-01-01

    Based on data from the National Medical Care Utilization and Expenditure Survey, the 10 percent of the noninstitutionalized U.S. population that incurred the highest medical care charges was responsible for 75 percent of all incurred charges. Health status was the strongest predictor of high-cost use, followed by economic factors. Persons 65 years of age or over incurred far higher costs than younger persons and had higher out-of-pocket costs, absolutely and as a percentage of income, althoug...

  6. Quality of Higher Education

    DEFF Research Database (Denmark)

    Zou, Yihuan

    is about constructing a more inclusive understanding of quality in higher education through combining the macro, meso and micro levels, i.e. from the perspectives of national policy, higher education institutions as organizations in society, individual teaching staff and students. It covers both......Quality in higher education was not invented in recent decades – universities have always possessed mechanisms for assuring the quality of their work. The rising concern over quality is closely related to the changes in higher education and its social context. Among others, the most conspicuous...... changes are the massive expansion, diversification and increased cost in higher education, and new mechanisms of accountability initiated by the state. With these changes the traditional internally enacted academic quality-keeping has been given an important external dimension – quality assurance, which...

  7. The cost of electrocoagulation

    Energy Technology Data Exchange (ETDEWEB)

    Donini, J.C.; Kan, J.; Szynkarczuk, J.; Hassan, T.A.; Kar, K.L.

    1993-01-01

    Electrocoagulation could be an attractive and suitable method for separating solids from waste water. The electrocoagulation of kaolinite and bentonite suspensions was studied in a pilot electrocoagulation unit to assess the cost and efficiency of the process. Factors affecting cost such as the formation of passivation layers on electrode plates and the recirculation and concentration of sodium chloride were examined. Colorimetry was used to analyze aluminum content in the suspension. The results were used to calculate the cost due to consumption of electrode material (aluminium) during the process. Total cost was assumed to comprise the energy cost and the cost of electrode material. Comparison was based on the settling properties of the treated product: turbidity, settling rate, and cake height. In most cases, aluminium efficiency averaged around 200% and material cost accounted for 80% of total cost. Although higher concentrations of sodium chloride could only slightly increase aluminium efficiency and electrode efficiency, the higher concentrations resulted in much greater total cost, due to the greater current generated by the increased suspension conductivity, which in turn dissolved a larger amount of aluminium. The recirculation loop increased the flow rate by 3-10 times, enhancing the mass transport between the electrodes and resulting in lower cost and better settling properties. Over the course of two months the electrodes coatings became thicker while efficiency decreased. The electrode efficiency was found to be as high as 94% for virgin electrodes and as low as 10% after two months. 8 refs., 25 figs., 9 tabs.

  8. Lowering Business Education Cost with a Custom Professor-Written Online Text

    Science.gov (United States)

    Baker-Eveleth, Lori Jo; Miller, Jon Robert; Tucker, Laura

    2011-01-01

    Inflation-adjusted tuition and fees in education have risen for decades. College textbook costs have risen as well. The authors discuss reasons for higher textbook costs. The development and use of encyclopedic introductory textbooks creates higher monetary cost for students and higher nonmonetary cost for students and teachers, from increased…

  9. Effects of housing system on the costs of commercial egg production1

    Science.gov (United States)

    Matthews, W. A.; Sumner, D. A.

    2014-01-01

    This article reports the first publicly available egg production costs compared across 3 hen-housing systems. We collected detailed data from 2 flock cycles from a commercial egg farm operating a conventional barn, an aviary, and an enriched colony system at the same location. The farm employed the same operational and accounting procedures for each housing system. Results provide clear evidence that egg production costs are much higher for the aviary system than the other 2 housing systems. Feed costs per dozen eggs are somewhat higher for the aviary and lower for the enriched house compared with the conventional house. Labor costs are much lower for the conventional house than the other 2, and pullet costs are much higher for the aviary. Energy and miscellaneous costs are a minimal part of total operating costs and do not differ by housing system. Total capital investments per hen-capacity are much higher for the aviary and the enriched house. Capital costs per dozen eggs depend on assumptions about appropriate interest and depreciation rates. Using the same 10% rate for each housing system shows capital costs per dozen for the aviary and the enriched housing system are much higher than capital costs per dozen for the conventional house. The aviary has average operating costs (feed, labor, pullet, energy, and miscellaneous costs that recur for each flock and vary with egg production) about 23% higher and average total costs about 36% higher compared with the conventional house. The enriched housing system has average operating costs only about 4% higher compared with the conventional house, but average total costs are 13% higher than for the conventional house. PMID:25480736

  10. Females with a mutation in a nuclear-encoded mitochondrial protein pay a higher cost of survival than do males in Drosophila.

    Science.gov (United States)

    Melvin, Richard G; Ballard, J William O

    2011-07-01

    Males and females age at different rates in a variety of species, but the mechanisms underlying the difference is not understood. In this study, we investigated sex-specific costs of a naturally occurring mildly deleterious deletion (DTrp85, DVal86) in cytochrome c oxidase subunit 7A (cox7A) in Drosophila simulans. We observed that females and males homozygous for the mutation had 30% and 26% reduced Cox activity, respectively, compared with wild type. Furthermore, 4-day-old females had 34%-42% greater physical activity than males. Greater physical activity in mutant females was correlated with a 19% lower 50% survival compared with wild-type females. Mutant and wild-type males had equal survival. These data suggest that females paid a higher cost of the mutation than did males. The data demonstrate linking population genetics and structural modeling to experimental manipulations that lead to functional predictions of mitochondrial bioenergetics and organism aging.

  11. National Variation in Urethroplasty Cost and Predictors of Extreme Cost: A Cost Analysis With Policy Implications.

    Science.gov (United States)

    Harris, Catherine R; Osterberg, E Charles; Sanford, Thomas; Alwaal, Amjad; Gaither, Thomas W; McAninch, Jack W; McCulloch, Charles E; Breyer, Benjamin N

    2016-08-01

    To determine which factors are associated with higher costs of urethroplasty procedure and whether these factors have been increasing over time. Identification of determinants of extreme costs may help reduce cost while maintaining quality. We conducted a retrospective analysis using the 2001-2010 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS). The HCUP-NIS captures hospital charges which we converted to cost using the HCUP cost-to-charge ratio. Log cost linear regression with sensitivity analysis was used to determine variables associated with increased costs. Extreme cost was defined as the top 20th percentile of expenditure, analyzed with logistic regression, and expressed as odds ratios (OR). A total of 2298 urethroplasties were recorded in NIS over the study period. The median (interquartile range) calculated cost was $7321 ($5677-$10,000). Patients with multiple comorbid conditions were associated with extreme costs [OR 1.56, 95% confidence interval (CI) 1.19-2.04, P = .02] compared with patients with no comorbid disease. Inpatient complications raised the odds of extreme costs (OR 3.2, CI 2.14-4.75, P costs (OR 1.78, 95% CI 1.2-2.64, P = .005). Variations in patient age, race, hospital region, bed size, teaching status, payor type, and volume of urethroplasty cases were not associated with extremes of cost. Cost variation for perioperative inpatient urethroplasty procedures is dependent on preoperative patient comorbidities, postoperative complications, and surgical complexity related to graft usage. Procedural cost and cost variation are critical for understanding which aspects of care have the greatest impact on cost. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. The influence of stormwater management practices on denitrification rates of receiving streams in an urban watershed

    Science.gov (United States)

    Cronenberger, M. S.; McMillan, S. K.

    2011-12-01

    Increasing urbanization and the subsequent disruption of floodplains has led to the need for implementing stormwater management strategies to mitigate the effects of urbanization, including soil and streambank erosion, increased export of nutrients and contaminants and decreased biotic richness. Excessive stormwater runoff due to the abundance of impervious surfaces associated with an urban landscape has led to the ubiquitous use of best management practices (BMPs) to attenuate runoff events and prevent the destructive delivery of large volumes of water to stream channels. As a result, effluent from BMPs (i.e. wetlands and wet ponds) has the potential to alter the character of the receiving stream channel and thus, key ecosystem processes such as denitrification. The purpose of this study was to determine the extent to which BMPs, in the form of constructed wetlands and wet ponds, influence in-stream denitrification rates in the urban landscape of Charlotte, NC. Four sites, two of each BMP type, were evaluated. Sediment samples were collected upstream and downstream of the BMP outflow from May-July 2011 to determine the effect of wetland discharge on in-stream nitrogen removal via denitrification. Denitrification rates were determined using the acetylene block method; water column nutrient and carbon concentrations and sediment organic matter content were also measured. Generally, wetland sites exhibited higher denitrification rates, nitrate concentrations and sediment organic matter content. Our work and others has demonstrated a significant positive correlation between nitrate concentration and denitrification rates, which is the likely driver of the higher observed rates at the wetland sites. Geomorphology was also found to be a key factor in elevated denitrification rates at sites with riffles and boulder jams. Sediment organic matter was found to be higher downstream of BMP outflows at all four sites, but demonstrated no significant relationship with

  13. Attrition Cost Model Instruction Manual

    Science.gov (United States)

    Yanagiura, Takeshi

    2012-01-01

    This instruction manual explains in detail how to use the Attrition Cost Model program, which estimates the cost of student attrition for a state's higher education system. Programmed with SAS, this model allows users to instantly calculate the cost of attrition and the cumulative attrition rate that is based on the most recent retention and…

  14. Net Shape Spin Formed Cryogenic Aluminum Lithium Cryogenic Tank Domes for Lower Cost Higher Performance Launch Vehicles

    Science.gov (United States)

    Curreri, Peter A.; Hoffman, Eric; Domack, Marcia; Brewster, Jeb; Russell, Carolyn

    2013-01-01

    With the goal of lower cost (simplified manufacturing and lower part count) and higher performance (higher strength to weight alloys) the NASA Technical Maturation Program in 2006 funded a proposal to investigate spin forming of space launch vehicle cryogenic tank domes. The project funding continued under the NASA Exploration Technology Development Program through completion in FY12. The first phase of the project involved spin forming of eight, 1 meter diameter "path finder" domes. Half of these were processed using a concave spin form process (MT Aerospace, Augsburg Germany) and the other half using a convex process (Spincraft, Boston MA). The convex process has been used to produce the Ares Common Bulkhead and the concave process has been used to produce dome caps for the Space Shuttle light weight external tank and domes for the NASDA H2. Aluminum Lithium material was chosen because of its higher strength to weight ratio than the Aluminum 2219 baseline. Aluminum lithium, in order to obtain the desired temper (T8), requires a cold stretch after the solution heat treatment and quench. This requirement favors the concave spin form process which was selected for scale up. This paper describes the results of processing four, 5.5 meter diameter (upper stage scale) net shaped spin formed Aluminum Lithium domes. In order to allow scalability beyond the limits of foundry and rolling mills (about 12 foot width) the circular blank contained one friction stir weld (heavy lifter scales require a flat blank containing two welds). Mechanical properties data (tensile, fracture toughness, stress corrosion, and simulated service testing) for the parent metal and weld will also be discussed.

  15. Bone morphogenetic protein-induced heterotopic bone formation: What have we learned from the history of a half century?

    Directory of Open Access Journals (Sweden)

    Takenobu Katagiri, PhD

    2015-05-01

    Full Text Available Bone morphogenetic protein (BMP was originally discovered by Marshall Urist a half century ago following the observation of a unique activity that induced heterotopic bone formation in skeletal muscle tissue. The molecular mechanisms underlying the induction of heterotopic bone formation in skeletal muscle by BMPs were elucidated through the purification and molecular cloning of BMPs and identification of their functional receptors and downstream effectors, as well as from genetic disorders related to BMP activity. BMPs are important regulators of not only skeletal development and regeneration but also the homeostasis of normal skeletal muscle mass. There is still much to learn about the physiology and pathology at the interface of BMPs and skeletal muscle.

  16. Who Should Pay for Higher Education?

    Science.gov (United States)

    Bou-Habib, Paul

    2010-01-01

    Policies that shift the costs of higher education from the taxpayer to the university student or graduate are increasingly popular, yet they have not been subjected to a thorough normative analysis. This paper provides a critical survey of the standard arguments that have been used in the public debate on higher education funding. These arguments…

  17. Cost-based droop scheme with lower generation costs for microgrids

    DEFF Research Database (Denmark)

    Nutkani, Inam Ullah; Loh, Poh Chiang; Blaabjerg, Frede

    2014-01-01

    -based droop scheme, whose objective is to reduce a generation cost function realised with various DG operating characteristics taken into consideration. Where desired, proportional power sharing based on the DG kVA ratings can also be included, whose disadvantage is a slightly higher generation cost, which...... on the DG kilovolts ampere (kVA) ratings. Other factors like generation costs, efficiencies and emission penalties at different load demands have not been considered. This omission might not be appropriate if different types of DGs are present in the microgrids. As an alternative, this study proposes a cost...... is still lower than that produced by the traditional droop schemes. The proposed droop scheme therefore retains all advantages of the traditional droop schemes, whereas at the same time, keeps its generation cost low. These findings have been validated in experiments....

  18. Stormwater management impacts on urban stream water quality and quantity during and after development in Clarksburg, MD

    Science.gov (United States)

    Loperfido, J. V.; Noe, G. B.; Jarnagin, S.; Mohamoud, Y. M.; Van Ness, K.; Hogan, D. M.

    2012-12-01

    Urbanization and urban land use leads to degradation of local stream habitat and 'urban stream syndrome.' Best Management Practices (BMPs) are often used in an attempt to mitigate the impact of urban land use on stream water quality and quantity. Traditional development has employed stormwater BMPs that were placed in a centralized manner located either in the stream channel or near the riparian zone to treat stormwater runoff from large drainage areas; however, urban streams have largely remained impaired. Recently, distributed placement of BMPs throughout the landscape has been implemented in an attempt to detain, treat, and infiltrate stormwater runoff from smaller drainage areas near its source. Despite increasing implementation of distributed BMPs, little has been reported on the catchment-scale (1-10 km^2) performance of distributed BMPs and how they compare to centralized BMPs. The Clarksburg Special Protection Area (CSPA), located in the Washington, DC exurbs within the larger Chesapeake Bay watershed, is undergoing rapid urbanization and employs distributed BMPs on the landscape that treat small drainage areas with the goal of preserving high-quality stream resources in the area. In addition, the presence of a nearby traditionally developed (centralized BMPs) catchment and an undeveloped forested catchment makes the CSPA an ideal setting to understand how the best available stormwater management technology implemented during and after development affects stream water quality and quantity through a comparative watershed analysis. The Clarksburg Integrated Monitoring Partnership is a consortium of local and federal agencies and universities that conducts research in the CSPA including: monitoring of stream water quality, geomorphology, and biology; analysis of stream hydrological and water quality data; and GIS mapping and analysis of land cover, elevation change and BMP implementation data. Here, the impacts of urbanization on stream water quantity

  19. The cost of tuberculosis in Denmark

    DEFF Research Database (Denmark)

    Fløe, Andreas; Hilberg, Ole; Wejse, Christian

    Hypothesis: Tuberculosis (TB) patients carry higher direct health-related and indirect costs than the general population. Objective: To calculate the economic burden of TB in Denmark, including the health-related costs of treatment and the indirect costs for society in a national retrospective case...

  20. Bone morphogenetic proteins: from structure to clinical use

    Directory of Open Access Journals (Sweden)

    Granjeiro J.M.

    2005-01-01

    Full Text Available Bone morphogenetic proteins (BMPs are multi-functional growth factors belonging to the transforming growth factor ß superfamily. Family members are expressed during limb development, endochondral ossification, early fracture, and cartilage repair. The activity of BMPs was first identified in the 1960s but the proteins responsible for bone induction were unknown until the purification and cloning of human BMPs in the 1980s. To date, about 15 BMP family members have been identified and characterized. The signal triggered by BMPs is transduced through serine/threonine kinase receptors, type I and II subtypes. Three type I receptors have been shown to bind BMP ligands, namely: type IA and IB BMP receptors and type IA activin receptors. BMPs seem to be involved in the regulation of cell proliferation, survival, differentiation and apoptosis, but their hallmark is their ability to induce bone, cartilage, ligament, and tendon formation at both heterotopic and orthotopic sites. This suggests that, in the future, they may play a major role in the treatment of bone diseases. Several animal studies have illustrated the potential of BMPs to enhance spinal fusion, repair critical-size defects, accelerate union, and heal articular cartilage lesions. Difficulties in producing and purifying BMPs from bone tissue have prompted the attempts made by several laboratories, including ours, to express these proteins in the recombinant form in heterologous systems. This review focuses on BMP structure, molecular mechanisms of action and significance and potential applications in medical, dental and veterinary practice for the treatment of cartilage and bone-related diseases.

  1. The Future Train Wreck: Paying for Medical Costs for Higher Education's Retirees

    Science.gov (United States)

    Biggs, John H.

    2006-01-01

    Trustees and administrators today confront one of two problems with post-retirement medical care. First, if institutions provide no support for their retirees' medical care, they implicitly offer a powerful incentive for senior faculty to stay on. The compensation and opportunity costs of this effect are obviously very high. But, second, if they…

  2. Activity-based costing methodology as tool for costing in hematopathology laboratory.

    Science.gov (United States)

    Gujral, Sumeet; Dongre, Kanchan; Bhindare, Sonal; Subramanian, P G; Narayan, Hkv; Mahajan, Asim; Batura, Rekha; Hingnekar, Chitra; Chabbria, Meenu; Nair, C N

    2010-01-01

    Cost analysis in laboratories represents a necessary phase in their scientific progression. To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL). Activity-based costing (ABC) method is used to calculate per cost test of the hematopathology laboratory. Information is collected from registers, purchase orders, annual maintenance contracts (AMCs), payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC), bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

  3. Batteries: Lower cost than gasoline?

    International Nuclear Information System (INIS)

    Werber, Mathew; Fischer, Michael; Schwartz, Peter V.

    2009-01-01

    We compare the lifecycle costs of an electric car to a similar gasoline-powered vehicle under different scenarios of required driving range and cost of gasoline. An electric car is cost competitive for a significant portion of the scenarios: for cars of lower range and for higher gasoline prices. Electric cars with ∼150 km range are a technologically viable, cost competitive, high performance, high efficiency alternative that can presently suit the vast majority of consumers' needs.

  4. Bone morphogenic protein: an elixir for bone grafting--a review.

    Science.gov (United States)

    Shah, Prasun; Keppler, Louis; Rutkowski, James

    2012-12-01

    Bone morphogenetic proteins (BMPs) are multifunctional growth factors that belong to the transforming growth factor beta superfamily. This literature review focuses on the molecular biology of BMPs, their mechanism of action, and subsequent applications. It also discusses uses of BMPs in the fields of dentistry and orthopedics, research on methods of delivering BMPs, and their role in tissue regeneration. BMP has positive effects on bone grafts, and their calculated and timely use with other growth factors can provide extraordinary results in fractured or nonhealing bones. Use of BMP introduces new applications in the field of implantology and bone grafting. This review touches on a few unknown facts about BMP and this ever-changing field of research to improve human life.

  5. Instructional Cost Analysis: History and Present Inadequacies.

    Science.gov (United States)

    Humphrey, David A.

    The cost analysis of instruction is conducted according to principles of teaching and learning that have often become historically dated. Using today's costing systems prevents determination of whether cost effectiveness actually exists. The patterns of instruction in higher education and the systems employed for instructional cost analysis are…

  6. Cost of illness and determinants of costs among patients with gout.

    Science.gov (United States)

    Spaetgens, Bart; Wijnands, José M A; van Durme, Caroline; van der Linden, Sjef; Boonen, Annelies

    2015-02-01

    To estimate costs of illness in a cross-sectional cohort of patients with gout attending an outpatient rheumatology clinic, and to evaluate which factors contribute to higher costs. Altogether, 126 patients with gout were clinically assessed. They completed a series of questionnaires. Health resource use was collected using a self-report questionnaire that was cross-checked with the electronic patient file. Productivity loss was assessed by the Work Productivity and Activity Impairment Questionnaire, addressing absenteeism and presenteeism. Resource use and productivity loss were valued by real costs, and annual costs per patient were calculated. Factors contributing to incurring costs above the median were explored using logistic univariable and multivariable regression analysis. Mean (median) annual direct costs of gout were €5647 (€1148) per patient. Total costs increased to €6914 (€1279) or €10,894 (€1840) per patient per year when adding cost for absenteeism or both absenteeism and presenteeism, respectively. Factors independently associated with high direct and high indirect costs were a positive history of cardiovascular disease, functional limitations, and female sex. In addition, pain, gout concerns, and unmet gout treatment needs were associated with high direct costs. The direct and indirect costs-of-illness of gout are primarily associated with cardiovascular disease, functional limitations, and female sex.

  7. Nuclear thermal propulsion engine cost trade studies

    International Nuclear Information System (INIS)

    Paschall, R.K.

    1993-01-01

    The NASA transportation strategy for the Mars Exploration architecture includes the use of nuclear thermal propulsion as the primary propulsion system for Mars transits. It is anticipated that the outgrowth of the NERVA/ROVER programs will be a nuclear thermal propulsion (NTP) system capable of providing the propulsion for missions to Mars. The specific impulse (Isp) for such a system is expected to be in the 870 s range. Trade studies were conducted to investigate whether or not it may be cost effective to invest in a higher performance (Isp>870 s) engine for nuclear thermal propulsion for missions to Mars. The basic cost trades revolved around the amount of mass that must be transported to low-earth orbit prior to each Mars flight and the cost to launch that mass. The mass required depended on the assumptions made for Mars missions scenarios including piloted/cargo flights, number of Mars missions, and transit time to Mars. Cost parameters included launch cost, program schedule for development and operations, and net discount rate. The results were very dependent on the assumptions that were made. Under some assumptions, higher performance engines showed cost savings in the billions of dollars; under other assumptions, the additional cost to develop higher performance engines was not justified

  8. Breast and prostate cancer productivity costs: a comparison of the human capital approach and the friction cost approach.

    Science.gov (United States)

    Hanly, Paul; Timmons, Aileen; Walsh, Paul M; Sharp, Linda

    2012-05-01

    Productivity costs constitute a substantial proportion of the total societal costs associated with cancer. We compared the results of applying two different analytical methods--the traditional human capital approach (HCA) and the emerging friction cost approach (FCA)--to estimate breast and prostate cancer productivity costs in Ireland in 2008. Data from a survey of breast and prostate cancer patients were combined with population-level survival estimates and a national wage data set to calculate costs of temporary disability (cancer-related work absence), permanent disability (workforce departure, reduced working hours), and premature mortality. For breast cancer, productivity costs per person using the HCA were € 193,425 and those per person using the FCA were € 8,103; for prostate cancer, the comparable estimates were € 109,154 and € 8,205, respectively. The HCA generated higher costs for younger patients (breast cancer) because of greater lifetime earning potential. In contrast, the FCA resulted in higher productivity costs for older male patients (prostate cancer) commensurate with higher earning capacity over a shorter time period. Reduced working hours postcancer was a key driver of total HCA productivity costs. HCA costs were sensitive to assumptions about discount and growth rates. FCA costs were sensitive to assumptions about the friction period. The magnitude of the estimates obtained in this study illustrates the importance of including productivity costs when considering the economic impact of illness. Vastly different results emerge from the application of the HCA and the FCA, and this finding emphasizes the importance of choosing the study perspective carefully and being explicit about assumptions that underpin the methods. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. Activity-based costing methodology as tool for costing in hematopathology laboratory

    Directory of Open Access Journals (Sweden)

    Gujral Sumeet

    2010-01-01

    Full Text Available Background: Cost analysis in laboratories represents a necessary phase in their scientific progression. Aim: To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL Settings and Design: Activity-based costing (ABC method is used to calculate per cost test of the hematopathology laboratory. Material and Methods: Information is collected from registers, purchase orders, annual maintenance contracts (AMCs, payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Results: Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Conclusions: Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC, bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

  10. The Rapid Transit System That Achieves Higher Performance with Lower Life-Cycle Costs

    Science.gov (United States)

    Sone, Satoru; Takagi, Ryo

    In the age of traction system made of inverter and ac traction motors, distributed traction system with pure electric brake of regenerative mode has been recognised very advantageous. This paper proposes a new system as the lowest life-cycle cost system for high performance rapid transit, a new architecture and optimum parameters of power feeding system, and a new running method of trains. In Japan, these components of this proposal, i.e. pure electric brake and various countermeasures of reducing loss of regeneration have been already popular but not as yet the new running method for better utilisation of the equipment and for lower life-cycle cost. One example of what are proposed in this paper will be made as Tsukuba Express, which is under construction as the most modern commuter railway in Greater Tokyo area.

  11. Overview of Commercial Building Partnerships in Higher Education

    Energy Technology Data Exchange (ETDEWEB)

    Schatz, Glenn [Energy Efficiency and Renewable Energy (EERE), Washington, DC (United States)

    2013-03-01

    Higher education uses less energy per square foot than most commercial building sectors. However, higher education campuses house energy-intensive laboratories and data centers that may spend more than this average; laboratories, in particular, are disproportionately represented in the higher education sector. The Commercial Building Partnership (CBP), a public/private, cost-shared program sponsored by the U.S. Department of Energy (DOE), paired selected commercial building owners and operators with representatives of DOE, its national laboratories, and private-sector technical experts. These teams explored energy-saving measures across building systems–including some considered too costly or technologically challenging–and used advanced energy modeling to achieve peak whole-building performance. Modeling results were then included in new construction or retrofit designs to achieve significant energy reductions.

  12. Analysis of Best Management Practices Implementation on Water Quality Using the Soil and Water Assessment Tool

    OpenAIRE

    Jason Motsinger; Prasanta Kalita; Rabin Bhattarai

    2016-01-01

    The formation of hypoxic zone in the Gulf of Mexico can be traced to agricultural watersheds in the Midwestern United States that are artificially drained in order to make the land suitable for agriculture. A number of best management practices (BMPs) have been introduced to improve the water quality in the region but their relative effectivenss of these BMPs in reducing nutrient load has not been properly quantified. In order to determine the BMPs useful for reducing nutrient discharge from ...

  13. Economic costs of social phobia: a population-based study.

    Science.gov (United States)

    Acarturk, C; Smit, Filip; de Graaf, R; van Straten, A; Ten Have, M; Cuijpers, P

    2009-06-01

    Information about the economic costs of social phobia is scant. In this study, we examine the economic costs of social phobia and subthreshold social phobia. Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population-based prospective study (n=4,789). Costs related to health service uptake, patients' out-of-pocket expenses, and costs arising from production losses were calculated for the reference year 2003. The costs for people with social phobia were compared with the costs for people with no mental disorder. The annual per capita total costs of social phobia were euro 11,952 (95% CI=7,891-16,013) which is significantly higher than the total costs for people with no mental disorder, euro 2957 (95% CI=2690-3224). When adjusting for mental and somatic co-morbidity, the costs decreased to euro 6,100 (95% CI=2681-9519), or 136 million euro per year per 1 million inhabitants, which was still significantly higher than the costs for people with no mental disorder. The costs of subthreshold social phobia were also significantly higher than the costs for people without any mental disorder, at euro 4,687 (95% CI=2557-6816). The costs presented here are conservative lower estimates because we only included costs related to mental health services. The economic costs associated with social phobia are substantial, and those of subthreshold social phobia approach those of the full-blown disorder.

  14. Higher-order techniques in computational electromagnetics

    CERN Document Server

    Graglia, Roberto D

    2016-01-01

    Higher-Order Techniques in Computational Electromagnetics explains 'high-order' techniques that can significantly improve the accuracy, computational cost, and reliability of computational techniques for high-frequency electromagnetics, such as antennas, microwave devices and radar scattering applications.

  15. Integrating Social Media Technologies in Higher Education: Costs-Benefits Analysis

    Science.gov (United States)

    Okoro, Ephraim

    2012-01-01

    Social networking and electronic channels of communication are effective tools in the process of teaching and learning and have increasingly improved the quality of students' learning outcomes in higher education in recent years. The process encourages students' active engagement, collaboration, and participation in class activities and group…

  16. Stop Misusing Higher Education-Specific Price Indices

    Science.gov (United States)

    Gillen, Andrew; Robe, Jonathan

    2011-01-01

    In order to compare the price of things over time, it is necessary to use a price index to adjust for inflation. The Higher Education Price Index (HEPI) and the Higher Education Cost Adjustment (HECA) were designed to more accurately account for the spending patterns of colleges and universities. However, there are some methodological problems…

  17. Can delivery systems use cost-effectiveness analysis to reduce healthcare costs and improve value?

    Science.gov (United States)

    Savitz, Lucy A; Savitz, Samuel T

    2016-01-01

    Understanding costs and ensuring that we demonstrate value in healthcare is a foundational presumption as we transform the way we deliver and pay for healthcare in the U.S. With a focus on population health and payment reforms underway, there is increased pressure to examine cost-effectiveness in healthcare delivery. Cost-effectiveness analysis (CEA) is a type of economic analysis comparing the costs and effects (i.e. health outcomes) of two or more treatment options. The result is expressed as a ratio where the denominator is the gain in health from a measure (e.g. years of life or quality-adjusted years of life) and the numerator is the incremental cost associated with that health gain. For higher cost interventions, the lower the ratio of costs to effects, the higher the value. While CEA is not new, the approach continues to be refined with enhanced statistical techniques and standardized methods. This article describes the CEA approach and also contrasts it to optional approaches, in order for readers to fully appreciate caveats and concerns. CEA as an economic evaluation tool can be easily misused owing to inappropriate assumptions, over reliance, and misapplication. Twelve issues to be considered in using CEA results to drive healthcare delivery decision-making are summarized. Appropriately recognizing both the strengths and the limitations of CEA is necessary for informed resource allocation in achieving the maximum value for healthcare services provided.

  18. Costs and Performance of English Mental Health Providers.

    Science.gov (United States)

    Moran, Valerie; Jacobs, Rowena

    2017-06-01

    Despite limited resources in mental health care, there is little research exploring variations in cost performance across mental health care providers. In England, a prospective payment system for mental health care based on patient needs has been introduced with the potential to incentivise providers to control costs. The units of payment under the new system are 21 care clusters. Patients are allocated to a cluster by clinicians, and each cluster has a maximum review period. The aim of this research is to explain variations in cluster costs between mental health providers using observable patient demographic, need, social and treatment variables. We also investigate if provider-level variables explain differences in costs. The residual variation in cluster costs is compared across providers to provide insights into which providers may gain or lose under the new financial regime. The main data source is the Mental Health Minimum Data Set (MHMDS) for England for the years 2011/12 and 2012/13. Our unit of observation is the period of time spent in a care cluster and costs associated with the cluster review period are calculated from NHS Reference Cost data. Costs are modelled using multi-level log-linear and generalised linear models. The residual variation in costs at the provider level is quantified using Empirical Bayes estimates and comparative standard errors used to rank and compare providers. There are wide variations in costs across providers. We find that variables associated with higher costs include older age, black ethnicity, admission under the Mental Health Act, and higher need as reflected in the care clusters. Provider type, size, occupancy and the proportion of formal admissions at the provider-level are also found to be significantly associated with costs. After controlling for patient- and provider-level variables, significant residual variation in costs remains at the provider level. The results suggest that some providers may have to increase

  19. Cost-of-illness studies and cost-effectiveness analyses in anxiety disorders: a systematic review.

    Science.gov (United States)

    Konnopka, Alexander; Leichsenring, Falk; Leibing, Eric; König, Hans-Helmut

    2009-04-01

    To review cost-of-illness studies (COI) and cost-effectiveness analyses (CEA) conducted for anxiety disorders. Based on a database search in Pubmed, PsychINFO and NHS EED, studies were classified according to various criteria. Cost data were inflated and converted to 2005 US-$ purchasing power parities (PPP). We finally identified 20 COI and 11 CEA of which most concentrated on panic disorder (PD) and generalized anxiety disorder (GAD). Differing inclusion of cost categories limited comparability of COI. PD and GAD tended to show higher direct costs per case, but lower direct cost per inhabitant than social and specific phobias. Different measures of effectiveness severely limited comparability of CEA. Overall CEA analysed 26 therapeutic or interventional strategies mostly compared to standard treatment, 8 of them resulting in lower better effectiveness and costs than the comparator. Anxiety disorders cause considerable costs. More research on phobias, more standardised inclusion of cost categories in COI and a wider use of comparable effectiveness measures (like QALYs) in CEA is needed.

  20. Cost Study Manual 1965-66.

    Science.gov (United States)

    Illinois State Board of Higher Education, Springfield.

    Procedures are presented for use in reporting costs for institutions of higher education in Illinois. Following the definition of various accounting functions, the scope of the cost and statistical report is delimited, and specifications are presented for the collection of data on students, courses, academic faculty records, and academic faculty…

  1. Political Economy of Cost-Sharing in Higher Education: The Case of Jordan

    Science.gov (United States)

    Kanaan, Taher H.; Al-Salamat, Mamdouh N.; Hanania, May D.

    2011-01-01

    This article analyzes patterns of expenditure on higher education in Jordan, explores the current system's adequacy, efficiency, and equity, and identifies its strengths and weaknesses in light of current constraints and future challenges. Among the constraints are the relatively low public expenditure on higher education, leaving households to…

  2. Societal costs of multiple sclerosis in Ireland.

    Science.gov (United States)

    Carney, Peter; O'Boyle, Derek; Larkin, Aidan; McGuigan, Christopher; O'Rourke, Killian

    2018-05-01

    This paper evaluates the impact of multiple sclerosis (MS) in Ireland, and estimates the associated direct, indirect, and intangible costs to society based on a large nationally representative sample. A questionnaire was developed to capture the demographics, disease characteristics, healthcare use, informal care, employment, and wellbeing. Referencing international studies, standardized survey instruments were included (e.g. CSRI, MFIS-5, EQ-5D) or adapted (EDSS) for inclusion in an online survey platform. Recruitment was directed at people with MS via the MS Society mailing list and social media platforms, as well as in traditional media. The economic costing was primarily conducted using a 'bottom-up' methodology, and national estimates were achieved using 'prevalence-based' extrapolation. A total of 594 people completed the survey in full. The sample had geographic, disease, and demographic characteristics indicating good representativeness. At an individual level, average societal cost was estimated at €47,683; the average annual costs for those with mild, moderate, and severe MS were calculated as €34,942, €57,857, and €100,554, respectively. For a total Irish MS population of 9,000, the total societal costs of MS amounted to €429m. Direct costs accounted for just 30% of the total societal costs, indirect costs amounted to 50% of the total, and intangible or QoL costs represented 20%. The societal cost associated with a relapse in the sample is estimated as €2,438. The findings highlight that up to 70% of the total costs associated with MS are not routinely counted. These "hidden" costs are higher in Ireland than the rest of Europe, due in part to significantly lower levels of workforce participation, a higher likelihood of permanent workforce withdrawal, and higher levels of informal care needs. The relationship between disease progression and costs emphasize the societal importance of managing and slowing the progression of the illness.

  3. Civilizing the 'Barbarian': a critical analysis of behaviour modification programmes in forensic psychiatry settings.

    Science.gov (United States)

    Holmes, Dave; Murray, Stuart J

    2011-04-01

    Drawing on the works of Erving Goffman and Michel Foucault, this article presents part of the results of a qualitative study conducted in a forensic psychiatry setting. For many years, behaviour modification programmes (BMPs) have been subjected to scrutiny and harsh criticism on the part of researchers, clinicians and professional organizations. Nevertheless, BMPs continue to be in vogue in some 'total' institutions, such as psychiatric hospitals and prisons. Discourse analysis of mute evidence available in situ was used to critically look at behaviour modification programmes. Compelling examples of behaviour modification care plans are used to illustrate our critical analysis and to support our claim that BMPs violate both scientific and ethical norms in the name of doing 'what is best' for the patients. We argue that the continued use of BMPs is not only flawed from a scientific perspective, but constitutes an unethical approach to the management of nursing care for mentally ill offenders. Nurse managers need to be aware that BMPs violate ethical standards in nursing. As a consequence, they should overtly question the use of these approaches in psychiatric nursing. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  4. Terminal patients in Belgian nursing homes: a cost analysis.

    Science.gov (United States)

    Simoens, Steven; Kutten, Betty; Keirse, Emmanuel; Vanden Berghe, Paul; Beguin, Claire; Desmedt, Marianne; Deveugele, Myriam; Léonard, Christian; Paulus, Dominique; Menten, Johan

    2013-06-01

    Policy makers and health care payers are concerned about the costs of treating terminal patients. This study was done to measure the costs of treating terminal patients during the final month of life in a sample of Belgian nursing homes from the health care payer perspective. Also, this study compares the costs of palliative care with those of usual care. This multicenter, retrospective cohort study enrolled terminal patients from a representative sample of nursing homes. Health care costs included fixed nursing home costs, medical fees, pharmacy charges, other charges, and eventual hospitalization costs. Data sources consisted of accountancy and invoice data. The analysis calculated costs per patient during the final month of life at 2007/2008 prices. Nineteen nursing homes participated in the study, generating a total of 181 patients. Total mean nursing home costs amounted to 3,243 € per patient during the final month of life. Total mean nursing home costs per patient of 3,822 € for patients receiving usual care were higher than costs of 2,456 € for patients receiving palliative care (p = 0.068). Higher costs of usual care were driven by higher hospitalization costs (p < 0.001). This study suggests that palliative care models in nursing homes need to be supported because such care models appear to be less expensive than usual care and because such care models are likely to better reflect the needs of terminal patients.

  5. The high cost of low-acuity ICU outliers.

    Science.gov (United States)

    Dahl, Deborah; Wojtal, Greg G; Breslow, Michael J; Holl, Randy; Huguez, Debra; Stone, David; Korpi, Gloria

    2012-01-01

    Direct variable costs were determined on each hospital day for all patients with an intensive care unit (ICU) stay in four Phoenix-area hospital ICUs. Average daily direct variable cost in the four ICUs ranged from $1,436 to $1,759 and represented 69.4 percent and 45.7 percent of total hospital stay cost for medical and surgical patients, respectively. Daily ICU cost and length of stay (LOS) were higher in patients with higher ICU admission acuity of illness as measured by the APACHE risk prediction methodology; 16.2 percent of patients had an ICU stay in excess of six days, and these LOS outliers accounted for 56.7 percent of total ICU cost. While higher-acuity patients were more likely to be ICU LOS outliers, 11.1 percent of low-risk patients were outliers. The low-risk group included 69.4 percent of the ICU population and accounted for 47 percent of all LOS outliers. Low-risk LOS outliers accounted for 25.3 percent of ICU cost and incurred fivefold higher hospital stay costs and mortality rates. These data suggest that severity of illness is an important determinant of daily resource consumption and LOS, regardless of whether the patient arrives in the ICU with high acuity or develops complications that increase acuity. The finding that a substantial number of long-stay patients come into the ICU with low acuity and deteriorate after ICU admission is not widely recognized and represents an important opportunity to improve patient outcomes and lower costs. ICUs should consider adding low-risk LOS data to their quality and financial performance reports.

  6. Stormwater pollution treatment BMP discharge structures.

    Science.gov (United States)

    2014-03-01

    Structural best management practices (BMPs) are used to capture and treat stormwater runoff. Most structural BMPs provide treatment by filtering : runoff through a filter media or collecting it in a detention basin and slowly discharging it over an e...

  7. The nitrogen abatement cost in wetlands

    International Nuclear Information System (INIS)

    Bystroem, Olof

    1998-01-01

    The costs of abating agricultural nitrogen pollution in wetlands are estimated. By linking costs for construction of wetlands to the denitrification capacity of wetlands, an abatement cost function can be formed. A construction-cost function and a denitrification function for wetlands is estimated empirically. This paper establishes a link between abatement costs and the nitrogen load on wetlands. Since abatement costs fluctuate with nitrogen load, ignoring this link results in incorrect estimates of abatement costs. The results demonstrate that wetlands have the capacity to provide low cost abatement of nitrogen compounds in runoff. For the Kattegatt region in Sweden, marginal abatement costs for wetlands are shown to be lower than costs of land use changing measures, such as extended land under fallow or cultivation of fuel woods, but higher than the marginal costs of reducing nitrogen fertilizer

  8. Cost-identification analysis of total laryngectomy: an itemized approach to hospital costs.

    Science.gov (United States)

    Dedhia, Raj C; Smith, Kenneth J; Weissfeld, Joel L; Saul, Melissa I; Lee, Steve C; Myers, Eugene N; Johnson, Jonas T

    2011-02-01

    To understand the contribution of intraoperative and postoperative hospital costs to total hospital costs, examine the costs associated with specific hospital services in the postoperative period, and recognize the impact of patient factors on hospital costs. Case series with chart review. Large tertiary care teaching hospital system. Using the Pittsburgh Head and Neck Organ-Specific Database, 119 patients were identified as having total laryngectomy with bilateral selective neck dissection and primary closure from 1999 to 2009. Cost data were obtained for 112 patients. Costs include fixed and variable costs, adjusted to 2010 US dollars using the Consumer Price Index. Mean total hospital costs were $29,563 (range, $10,915 to $120,345). Operating room costs averaged 24% of total hospital costs, whereas room charges, respiratory therapy, laboratory, pharmacy, and radiology accounted for 38%, 14%, 8%, 7%, and 3%, respectively. Median length of stay was 9 days (range, 6-43), and median Charlson comorbidity index score was 8 (2-16). Patients with ≥1 day in the intensive care unit had significantly higher hospital costs ($46,831 vs $24,601, P cost differences with stratification based on previous radiation therapy ($27,598 vs $29,915 with no prior radiation, P = .62) or hospital readmission within 30 days ($29,483 vs $29,609 without readmission, P = .97). This is one of few studies in surgery and the first in otolaryngology to analyze hospital costs for a relatively standardized procedure. Further work will include cost analysis from multiple centers with investigation of global cost drivers.

  9. Factors Influencing Farmers’ Adoption of Best Management Practices: A Review and Synthesis

    Science.gov (United States)

    Best management practices (BMPs) for reducing agricultural non-point source pollution are widely available. However, agriculture remains a major global contributor to degradation of waters because farmers often do not adopt BMPs. To improve water quality, it is necessary to under...

  10. Predicting nonpoint stormwater runoff quality from land use

    Science.gov (United States)

    2018-01-01

    Evaluating the impact of urban development on natural ecosystem processes has become an increasingly complex task for planners, environmental scientists, and engineers. As the built environment continues to grow, unregulated nonpoint pollutants from increased human activity and large-scale development severely stress urban streams and lakes resulting in their currently impaired or degraded state. In response, integrated water quality management programs have been adopted to address these unregulated nonpoint pollutants by utilizing best management practices (BMPs) that treat runoff as close to the source as possible. Knowing where to install effective BMPs is no trivial task, considering budget constraints and the spatially extensive nature of nonpoint stormwater runoff. Accordingly, this paper presents an initial, straightforward and cost-effective methodology to identify critical nonpoint pollutant source watersheds through correlation of water quality with land use. Through an illustrative application to metropolitan Denver, Colorado, it is shown how this method can be used to aid stormwater professionals to evaluate and specify retrofit locations in need of water quality treatment features reduce, capture and treat stormwater runoff prior to entering receiving waters. PMID:29742172

  11. Electricity generation costs by source, and costs and benefits by substitutions of generation source

    International Nuclear Information System (INIS)

    Akimoto, Keigo; Oda, Junichiro; Sano, Fuminori

    2015-01-01

    After Fukushima-daiichi nuclear power accident, the Japanese government assessed the electricity generation costs by source in 2011. However, the conditions have been changing, and this study newly assessed the generation costs by source using new data. The generation costs for coal, oil, gas, nuclear, PV and wind power for 2013 and 2030 were estimated. According to the analysis, coal power is the cheapest when climate change damage costs are not considered, and nuclear power is the cheapest when the climate damage costs are considered. However, under the competitive electricity market in which power companies tend to invest in power plants with short-term payback investment preference, power companies will recognize higher costs of nuclear power particularly under highly uncertain nuclear regulation policies and energy policies. The policies to reduce the uncertainties are very important. (author)

  12. Lamb Production Costs: Analyses of Composition and Elasticities Analysis of Lamb Production Costs

    Directory of Open Access Journals (Sweden)

    C. Raineri

    2015-08-01

    Full Text Available Since lamb is a commodity, producers cannot control the price of the product they sell. Therefore, managing production costs is a necessity. We explored the study of elasticities as a tool for basing decision-making in sheep production, and aimed at investigating the composition and elasticities of lamb production costs, and their influence on the performance of the activity. A representative sheep production farm, designed in a panel meeting, was the base for calculation of lamb production cost. We then performed studies of: i costs composition, and ii cost elasticities for prices of inputs and for zootechnical indicators. Variable costs represented 64.15% of total cost, while 21.66% were represented by operational fixed costs, and 14.19% by the income of the factors. As for elasticities to input prices, the opportunity cost of land was the item to which production cost was more sensitive: a 1% increase in its price would cause a 0.2666% increase in lamb cost. Meanwhile, the impact of increasing any technical indicator was significantly higher than the impact of rising input prices. A 1% increase in weight at slaughter, for example, would reduce total cost in 0.91%. The greatest obstacle to economic viability of sheep production under the observed conditions is low technical efficiency. Increased production costs are more related to deficient zootechnical indexes than to high expenses.

  13. An overview of American higher education.

    Science.gov (United States)

    Baum, Sandy; Kurose, Charles; McPherson, Michael

    2013-01-01

    This overview of postsecondary education in the United States reviews the dramatic changes over the past fifty years in the students who go to college, the institutions that produce higher education, and the ways it is financed. The article, by Sandy Baum, Charles Kurose, and Michael McPherson, creates the context for the articles that follow on timely issues facing the higher education community and policy makers. The authors begin by observing that even the meaning of college has changed. The term that once referred primarily to a four-year period of academic study now applies to virtually any postsecondary study--academic or occupational, public or private, two-year or four-year-- that can result in a certificate or degree. They survey the factors underlying the expansion of postsecondary school enrollments; the substantial increases in female, minority, disadvantaged, and older students; the development of public community colleges; and the rise of for-profit colleges. They discuss the changing ways in which federal and state governments help students and schools defray the costs of higher education as well as more recent budget tensions that are now reducing state support to public colleges. And they review the forces that have contributed to the costs of producing higher education and thus rising tuitions. The authors also cite evidence on broad measures of college persistence and outcomes, including low completion rates at community and for-profit colleges, the increasing need for remedial education for poorly prepared high school students, and a growing gap between the earnings of those with a bachelor's degree and those with less education. They disagree with critics who say that investments in higher education, particularly for students at the margin, no longer pay off. A sustained investment in effective education at all levels is vital to the nation's future, they argue. But they caution that the American public no longer seems willing to pay more for

  14. Cleaning Management in Higher Education: Value for Money Study.

    Science.gov (United States)

    Scottish Higher Education Funding Council, Edinburgh.

    This report identifies key management issues for senior managers and heads of cleaning departments in developing and reviewing cleaning services to support improvement and enhance cost effectiveness. The cleaning costs incurred by higher education institutions (HEIs) represent 2.7 percent of the total spent nationally on cleaning services for both…

  15. Opinions of Forest Managers, Loggers, and Forest Landowners in North Carolina regarding Biomass Harvesting Guidelines

    Directory of Open Access Journals (Sweden)

    Diane Fielding

    2012-01-01

    Full Text Available Woody biomass has been identified as an important renewable energy source capable of offsetting fossil fuel use. The potential environmental impacts associated with using woody biomass for energy have spurred development of biomass harvesting guidelines (BHGs in some states and proposals for BHGs in others. We examined stakeholder opinions about BHGs through 60 semistructured interviews with key participants in the North Carolina, USA, forest business sector—forest managers, loggers, and forest landowners. Respondents generally opposed requirements for new BHGs because guidelines added to best management practices (BMPs. Most respondents believed North Carolina’s current BMPs have been successful and sufficient in protecting forest health; biomass harvesting is only an additional component to harvesting with little or no modification to conventional harvesting operations; and scientific research does not support claims that biomass harvesting negatively impacts soil, water quality, timber productivity, or wildlife habitat. Some respondents recognized possible benefits from the implementation of BHGs, which included reduced site preparation costs and increases in proactive forest management, soil quality, and wildlife habitat. Some scientific literature suggests that biomass harvests may have adverse site impacts that require amelioration. The results suggest BHGs will need to be better justified for practitioners based on the scientific literature or linked to demand from new profitable uses or subsidies to offset stakeholder perceptions that they create unnecessary costs.

  16. Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center.

    Science.gov (United States)

    Anzai, Yoshimi; Heilbrun, Marta E; Haas, Derek; Boi, Luca; Moshre, Kirk; Minoshima, Satoshi; Kaplan, Robert; Lee, Vivian S

    2017-02-01

    The lack of understanding of the real costs (not charge) of delivering healthcare services poses tremendous challenges in the containment of healthcare costs. In this study, we applied an established cost accounting method, the time-driven activity-based costing (TDABC), to assess the costs of performing an abdomen and pelvis computed tomography (AP CT) in an academic radiology department and identified opportunities for improved efficiency in the delivery of this service. The study was exempt from an institutional review board approval. TDABC utilizes process mapping tools from industrial engineering and activity-based costing. The process map outlines every step of discrete activity and duration of use of clinical resources, personnel, and equipment. By multiplying the cost per unit of capacity by the required task time for each step, and summing each component cost, the overall costs of AP CT is determined for patients in three settings, inpatient (IP), outpatient (OP), and emergency departments (ED). The component costs to deliver an AP CT study were as follows: radiologist interpretation: 40.1%; other personnel (scheduler, technologist, nurse, pharmacist, and transporter): 39.6%; materials: 13.9%; and space and equipment: 6.4%. The cost of performing CT was 13% higher for ED patients and 31% higher for inpatients (IP), as compared to that for OP. The difference in cost was mostly due to non-radiologist personnel costs. Approximately 80% of the direct costs of AP CT to the academic medical center are related to labor. Potential opportunities to reduce the costs include increasing the efficiency of utilization of CT, substituting lower cost resources when appropriate, and streamlining the ordering system to clarify medical necessity and clinical indications. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  17. Determining the economic cost of ICU treatment: a prospective "micro-costing" study.

    LENUS (Irish Health Repository)

    McLaughlin, Anne Marie

    2012-02-01

    OBJECTIVE: To prospectively assess the cost of patients in an adult intensive care unit (ICU) using bottom-up costing methodology and evaluate the usefulness of "severity of illness" scores in estimating ICU cost. METHODS AND DESIGN: A prospective study costing 64 consecutive admissions over a 2-month period in a mixed medical\\/surgical ICU. RESULTS: The median daily ICU cost (interquartile range, IQR) was 2,205 euro (1,932 euro-3,073 euro), and the median total ICU cost (IQR) was 10,916 euro (4,294 euro-24,091 euro). ICU survivors had a lower median daily ICU cost at 2,164 per day, compared with 3,496 euro per day for ICU non-survivors (P = 0.08). The requirements for continuous haemodiafiltration, blood products and anti-fungal agents were associated with higher daily and overall ICU costs (P = 0.002). Each point increase in SAPS3 was associated with a 305 euro (95% CI 31 euro-579 euro) increase in total ICU cost (P = 0.029). However, SAPS3 accounted for a small proportion of the variance in this model (R (2) = 0.08), limiting its usefulness as a stand-alone predictor of cost in clinical practice. A model including haemodiafiltration, blood products and anti-fungal agents explained 54% of the variance in total ICU cost. CONCLUSION: This bottom-up costing study highlighted the considerable individual variation in costs between ICU patients and identified the major factors contributing to cost. As the requirement for expensive interventions was the main driver for ICU cost, "severity of illness" scores may not be useful as stand-alone predictors of cost in the ICU.

  18. New benchmarks for costs and cost-efficiency of school-based feeding programs in food-insecure areas.

    Science.gov (United States)

    Gelli, Aulo; Cavallero, Andrea; Minervini, Licia; Mirabile, Mariana; Molinas, Luca; de la Mothe, Marc Regnault

    2011-12-01

    School feeding is a popular intervention that has been used to support the education, health and nutrition of school children. Although the benefits of school feeding are well documented, the evidence on the costs of such programs is remarkably thin. Address the need for systematic estimates of the cost of different school feeding modalities, and of the determinants of the considerable cost variation among countries. WFP project data, including expenditures and number of schoolchildren covered, were collected for 78 projects in 62 countries through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms. The standardized yearly average school feeding cost per child, not including school-level costs, was US$48. The yearly costs per child were lowest at US$23 for biscuit programs reaching school-going children and highest at US$75 for take-home rations programs reaching families of schoolgoing children. The average cost of programs combining on-site meals with extra take-home rations for children from vulnerable households was US$61. Commodity costs were on average 58% of total costs and were highest for biscuit and take-home rations programs (71% and 68%, respectively). Fortified biscuits provided the most cost-efficient option in terms of micronutrient delivery, whereas take-home rations were more cost-efficient in terms of food quantities delivered. Both costs and effects should be considered carefully when designing school feeding interventions. The average costs of school feeding estimated here are higher than those found in earlier studies but fall within the range of costs previously reported. Because this analysis does not include school-level costs, these

  19. The Opportunity Cost of Capital

    Directory of Open Access Journals (Sweden)

    Ayman Chit PhD

    2015-04-01

    Full Text Available The opportunity cost of the capital invested in pharmaceutical research and development (R&D to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this “hidden” cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost of capital concept and describe in detail how this value is calculated. Given the significant contribution of the cost of capital to the overall cost of new drug R&D, a clear understanding of the concept is critical for policy makers, investors, and those involved directly in the R&D.

  20. The Opportunity Cost of Capital

    Science.gov (United States)

    Chit, Ayman; Chit, Ahmad; Papadimitropoulos, Manny; Krahn, Murray; Parker, Jayson; Grootendorst, Paul

    2015-01-01

    The opportunity cost of the capital invested in pharmaceutical research and development (R&D) to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this “hidden” cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost of capital concept and describe in detail how this value is calculated. Given the significant contribution of the cost of capital to the overall cost of new drug R&D, a clear understanding of the concept is critical for policy makers, investors, and those involved directly in the R&D. PMID:25933615

  1. SUSTAIN - AN EPA BMP PROCESS AND PLACEMENT TOOL FOR URBAN WATERSHEDS

    Science.gov (United States)

    To assist stormwater management professionals in planning for implementation of best management practices (BMPs), efforts have been under way by the U.S. Environmental Protection Agency (EPA) since 2003 to develop a decision-support system for placement of BMPs at strategic locat...

  2. Implicit environmental costs in hydroelectric development

    International Nuclear Information System (INIS)

    Carlsen, A.J.; Wenstoep, F.; Strand, J.

    1992-01-01

    The ranking of hydropower projects under the Norwegian Master Plan for Water Resources is used to derive implicit government preferences for a number of environmental attributes described by ordinal scores for each project. Higher negative scores are generally associated with greater implicit willingness to pay to avoid the environmental damage tied to the attribute, caused by hydropower development. The total (ordinary economic and implicit environmental) cost for each project are derived, and the environmental costs per capacity unit are found to be on the same order as the economic costs, lower for projects ranked for early exploitation, and higher for projects to be saved permanently. An implicit long-run marginal cost curve for Norwegian hydropower development is derived, which is generally upward sloping, but not uniformly so. This can be due to the model specification problems or ranking inconsistencies, both of which are likely to be present. 11 refs., 7 figs., 1 tab

  3. Factor 10 Visions project: Higher Education Sector Towards Sustainable Higher Education: Environmental impacts of campus-based and distance higher education systems

    OpenAIRE

    Roy, Robin; Potter, Stephen; Yarrow, Karen; Smith, Mark

    2005-01-01

    This report gives the findings of a major UK study of the environmental impacts of four different methods of providing higher education (HE) courses: Conventional campus-based full-time courses; Conventional campus-based part-time courses; Print-based distance taught courses; Part electronically-delivered distance taught courses.\\ud This is an environmental assessment of these different HE systems and does not assess their educational effectiveness or socio-economic costs and benefits.\\ud KEY...

  4. Counting the Cost, Reconciling the Benefits: Understanding Employer Investment in Higher Apprenticeships in Accounting

    Science.gov (United States)

    Gambin, Lynn; Hogarth, Terence

    2016-01-01

    Lack of progression to higher education amongst those who complete an Advanced Apprenticeship in England and the country's need for higher level skills led to the introduction of Higher Apprenticeships in 2009. Whilst Higher Apprenticeships would be expected to facilitate learner progression, the volume of these has remained low. In this paper,…

  5. Using the soil and water assessment tool to estimate achievable water quality targets through implementation of beneficial management practices in an agricultural watershed.

    Science.gov (United States)

    Yang, Qi; Benoy, Glenn A; Chow, Thien Lien; Daigle, Jean-Louis; Bourque, Charles P-A; Meng, Fan-Rui

    2012-01-01

    Runoff from crop production in agricultural watersheds can cause widespread soil loss and degradation of surface water quality. Beneficial management practices (BMPs) for soil conservation are often implemented as remedial measures because BMPs can reduce soil erosion and improve water quality. However, the efficacy of BMPs may be unknown because it can be affected by many factors, such as farming practices, land-use, soil type, topography, and climatic conditions. As such, it is difficult to estimate the impacts of BMPs on water quality through field experiments alone. In this research, the Soil and Water Assessment Tool was used to estimate achievable performance targets of water quality indicators (sediment and soluble P loadings) after implementation of combinations of selected BMPs in the Black Brook Watershed in northwestern New Brunswick, Canada. Four commonly used BMPs (flow diversion terraces [FDTs], fertilizer reductions, tillage methods, and crop rotations), were considered individually and in different combinations. At the watershed level, the best achievable sediment loading was 1.9 t ha(-1) yr(-1) (89% reduction compared with default scenario), with a BMP combination of crop rotation, FDT, and no-till. The best achievable soluble P loading was 0.5 kg ha(-1) yr(-1) (62% reduction), with a BMP combination of crop rotation and FDT and fertilizer reduction. Targets estimated through nonpoint source water quality modeling can be used to evaluate BMP implementation initiatives and provide milestones for the rehabilitation of streams and rivers in agricultural regions. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  6. Open Educational Practices in Higher Education: Institutional Adoption and Challenges

    Science.gov (United States)

    Murphy, Angela

    2013-01-01

    Open educational resources and open education practices have the potential to lower costs and increase participation in higher education. One hundred and ten individuals from higher education institutions around the world participated in a survey aimed at identifying the extent to which higher education institutions are currently implementing open…

  7. Preterm birth-associated cost of early intervention services: an analysis by gestational age.

    Science.gov (United States)

    Clements, Karen M; Barfield, Wanda D; Ayadi, M Femi; Wilber, Nancy

    2007-04-01

    Characterizing the cost of preterm birth is important in assessing the impact of increasing prematurity rates and evaluating the cost-effectiveness of therapies to prevent preterm delivery. To assess early intervention costs that are associated with preterm births, we estimated the program cost of early intervention services for children who were born in Massachusetts, by gestational age at birth. Using the Pregnancy to Early Life Longitudinal Data Set, birth certificates for infants who were born in Massachusetts between July 1999 and June 2000 were linked to early intervention claims through 2003. We determined total program costs, in 2003 dollars, of early intervention and mean cost per surviving infant by gestational age. Costs by plurality, eligibility criteria, provider discipline, and annual costs for children's first 3 years also were examined. Overall, 14,033 of 76,901 surviving infants received early intervention services. Program costs totaled almost $66 million, with mean cost per surviving infant of $857. Mean cost per infant was highest for children who were 24 to 31 weeks' gestational age ($5393) and higher for infants who were 32 to 36 weeks' gestational age ($1578) compared with those who were born at term ($725). Cost per surviving infant generally decreased with increasing gestational age. Among children in early intervention, mean cost per child was higher for preterm infants than for term infants. At each gestational age, mean cost per surviving infant was higher for multiples than for singletons, and annual early intervention costs were higher for toddlers than for infants. Compared with their term counterparts, preterm infants incurred higher early intervention costs. This information along with data on birth trends will inform budget forecasting for early intervention programs. Costs that are associated with early childhood developmental services must be included when considering the long-term costs of prematurity.

  8. The costs and cost-effectiveness of an integrated sepsis treatment protocol.

    Science.gov (United States)

    Talmor, Daniel; Greenberg, Dan; Howell, Michael D; Lisbon, Alan; Novack, Victor; Shapiro, Nathan

    2008-04-01

    Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown. To assess the cost-effectiveness of an integrated sepsis protocol, as compared with conventional care. Prospective cohort study of consecutive patients presenting with septic shock and enrolled in the institution's integrated sepsis protocol. Clinical and economic outcomes were compared with a historical control cohort. Beth Israel Deaconess Medical Center. Overall, 79 patients presenting to the emergency department with septic shock in the treatment cohort and 51 patients in the control group. An integrated sepsis treatment protocol incorporating empirical antibiotics, early goal-directed therapy, intensive insulin therapy, lung-protective ventilation, and consideration for drotrecogin alfa and steroid therapy. In-hospital treatment costs were collected using the hospital's detailed accounting system. The cost-effectiveness analysis was performed from the perspective of the healthcare system using a lifetime horizon. The primary end point for the cost-effectiveness analysis was the incremental cost per quality-adjusted life year gained. Mortality in the treatment group was 20.3% vs. 29.4% in the control group (p = .23). Implementing an integrated sepsis protocol resulted in a mean increase in cost of approximately $8,800 per patient, largely driven by increased intensive care unit length of stay. Life expectancy and quality-adjusted life years were higher in the treatment group; 0.78 and 0.54, respectively. The protocol was associated with an incremental cost of $11,274 per life-year saved and a cost of $16,309 per quality-adjusted life year gained. In patients with septic shock, an integrated sepsis protocol, although not cost-saving, appears to be cost-effective and compares very favorably to other commonly delivered acute care interventions.

  9. User friendly tools to target vulnerable areas at watershed scale: evaluation of the soil vulnerability and conductivity claypan indices

    Science.gov (United States)

    One finding of the Conservation Effects Assessment Program (CEAP) watershed studies was that Best Management practices (BMPs) were not always installed where most needed: in many watersheds, only a fraction of BMPs were implemented in the most vulnerable areas. While complex computer simulation mode...

  10. Serum Proteases Potentiate BMP-Induced Cell Cycle Re-entry of Dedifferentiating Muscle Cells during Newt Limb Regeneration

    NARCIS (Netherlands)

    Wagner, Ines; Wang, Heng; Weissert, Philipp M.; Straube, Werner L.; Shevchenko, Anna; Gentzel, Marc; Brito, Goncalo; Tazaki, Akira; Oliveira, Catarina; Sugiura, Takuji; Shevchenko, Andrej; Simon, Andras; Drechsel, David N.; Tanaka, Elly M.

    2017-01-01

    Limb amputation in the newt induces myofibers to dedifferentiate and re-enter the cell cycle to generate proliferative myogenic precursors in the regeneration blastema. Here we show that bone morphogenetic proteins (BMPs) and mature BMPs that have been further cleaved by serum proteases induce cell

  11. Basolateral BMP signaling in polarized epithelial cells.

    Directory of Open Access Journals (Sweden)

    Masao Saitoh

    Full Text Available Bone morphogenetic proteins (BMPs regulate various biological processes, mostly mediated by cells of mesenchymal origin. However, the roles of BMPs in epithelial cells are poorly understood. Here, we demonstrate that, in polarized epithelial cells, BMP signals are transmitted from BMP receptor complexes exclusively localized at the basolateral surface of the cell membrane. In addition, basolateral stimulation with BMP increased expression of components of tight junctions and enhanced the transepithelial resistance (TER, counteracting reduction of TER by treatment with TGF-β or an anti-tumor drug. We conclude that BMPs maintain epithelial polarity via intracellular signaling from basolaterally localized BMP receptors.

  12. Analysis of Best Management Practices Implementation on Water Quality Using the Soil and Water Assessment Tool

    Directory of Open Access Journals (Sweden)

    Jason Motsinger

    2016-04-01

    Full Text Available The formation of hypoxic zone in the Gulf of Mexico can be traced to agricultural watersheds in the Midwestern United States that are artificially drained in order to make the land suitable for agriculture. A number of best management practices (BMPs have been introduced to improve the water quality in the region but their relative effectivenss of these BMPs in reducing nutrient load has not been properly quantified. In order to determine the BMPs useful for reducing nutrient discharge from a tile drained watershed, a Soil and Water Assessment Tool (SWAT model was calibrated and validated for water flow and nitrate load using experimental data from the Little Vermillion River (LVR watershed in east-central Illinois. Then, the performance of four common BMPs (reduced tillage, cover crop, filter strip and wetlands were evaluated. For BMPs, the usage of rye as cover crop performed the best in reducing nitrate discharge from the watershed as a single BMP, with an average annual nitrate load reduction of 54.5%. Combining no tillage and rye cover crops had varying results over the period simulated, but the average nitrate reduction was better than using rye cover crops with conventional tillage, with the average annual nitrate discharge decreased by 60.5% (an improvement of 13% over rye only.

  13. Preliminary cost estimating for the nuclear industry

    International Nuclear Information System (INIS)

    Klumpar, I.V.; Soltz, K.M.

    1985-01-01

    The nuclear industry has higher costs for personnel, equipment, construction, and engineering than conventional industry, which means that cost estimation procedures may need adjustment. The authors account for the special technical and labor requirements of the nuclear industry in making adjustments to equipment and installation cost estimations. Using illustrative examples, they show that conventional methods of preliminary cost estimation are flexible enough for application to emerging industries if their cost structure is similar to that of the process industries. If not, modifications can provide enough engineering and cost data for a statistical analysis. 9 references, 14 figures, 4 tables

  14. Experience that much work produces many reinforcers makes the sunk cost fallacy in pigeons: A preliminary test

    Directory of Open Access Journals (Sweden)

    Shun eFujimaki

    2016-03-01

    Full Text Available The sunk cost fallacy is one of the irrational choice behaviors robustly observed in humans. This fallacy can be defined as a preference for a higher-cost alternative to a lower-cost one after previous investment in a higher-cost alternative. The present study examined this irrational choice by exposing pigeons to several types of trials with differently illuminated colors. We prepared three types of nonchoice trials for experiencing different outcomes after presenting same or different colors as alternatives and three types of choice trials for testing whether pigeons demonstrated irrational choice. In nonchoice trials, animals experienced either of the following: (1 no reinforcement after the presentation of an unrelated colored stimulus to the alternatives used in the choice situation, (2 no reinforcement after investment in the lower-cost alternative, or (3 reinforcement or no reinforcement after investment in the higher-cost alternative. In choice trials, animals were required to choose in the following three situations: (A higher-cost vs. lower-cost alternatives, (B higher-cost vs. lower-cost ones after some investment in the higher-cost alternative, and (C higher-cost vs. lower-cost alternatives after the presentation of an unrelated colored stimulus. From the definition of the sunk cost fallacy, we assumed that animals would exhibit this fallacy if they

  15. Cost Estimating Handbook for Environmental Restoration

    International Nuclear Information System (INIS)

    1993-01-01

    Environmental restoration (ER) projects have presented the DOE and cost estimators with a number of properties that are not comparable to the normal estimating climate within DOE. These properties include: An entirely new set of specialized expressions and terminology. A higher than normal exposure to cost and schedule risk, as compared to most other DOE projects, due to changing regulations, public involvement, resource shortages, and scope of work. A higher than normal percentage of indirect costs to the total estimated cost due primarily to record keeping, special training, liability, and indemnification. More than one estimate for a project, particularly in the assessment phase, in order to provide input into the evaluation of alternatives for the cleanup action. While some aspects of existing guidance for cost estimators will be applicable to environmental restoration projects, some components of the present guidelines will have to be modified to reflect the unique elements of these projects. The purpose of this Handbook is to assist cost estimators in the preparation of environmental restoration estimates for Environmental Restoration and Waste Management (EM) projects undertaken by DOE. The DOE has, in recent years, seen a significant increase in the number, size, and frequency of environmental restoration projects that must be costed by the various DOE offices. The coming years will show the EM program to be the largest non-weapons program undertaken by DOE. These projects create new and unique estimating requirements since historical cost and estimating precedents are meager at best. It is anticipated that this Handbook will enhance the quality of cost data within DOE in several ways by providing: The basis for accurate, consistent, and traceable baselines. Sound methodologies, guidelines, and estimating formats. Sources of cost data/databases and estimating tools and techniques available at DOE cost professionals

  16. Counting the costs of accreditation in acute care: an activity-based costing approach.

    Science.gov (United States)

    Mumford, Virginia; Greenfield, David; Hogden, Anne; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

    2015-09-08

    To assess the costs of hospital accreditation in Australia. Mixed methods design incorporating: stakeholder analysis; survey design and implementation; activity-based costs analysis; and expert panel review. Acute care hospitals accredited by the Australian Council for Health Care Standards. Six acute public hospitals across four States. Accreditation costs varied from 0.03% to 0.60% of total hospital operating costs per year, averaged across the 4-year accreditation cycle. Relatively higher costs were associated with the surveys years and with smaller facilities. At a national level these costs translate to $A36.83 million, equivalent to 0.1% of acute public hospital recurrent expenditure in the 2012 fiscal year. This is the first time accreditation costs have been independently evaluated across a wide range of hospitals and highlights the additional cost burden for smaller facilities. A better understanding of the costs allows policymakers to assess alternative accreditation and other quality improvement strategies, and understand their impact across a range of facilities. This methodology can be adapted to assess international accreditation programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. The economic cost of pathways to care in first episode psychosis.

    LENUS (Irish Health Repository)

    Heslin, Margaret

    2011-01-01

    Few studies have examined the economic cost of psychoses other than schizophrenia and there have been no studies of the economic cost of pathways to care in patients with their first episode of psychosis. The aims of this study were to explore the economic cost of pathways to care in patients with a first episode of psychosis and to examine variation in costs. Data on pathways to care for first episode psychosis patients referred to specialist mental health services in south-east London and Nottingham between 1997-2000. Costs of pathway events were estimated and compared between diagnostic groups. The average costs for patients in south-east London were £54 (CI £33-£75) higher, compared to patients in Nottingham. Across both centres unemployed patients had £25 (CI £7-£43) higher average costs compared to employed patients. Higher costs were associated with being unemployed and living in south-east London and these differences could not be accounted for by any single factor. This should be considered when the National Health Service (NHS) is making decisions about funding.

  18. Analysis of Unit Costs in a University. The Fribourg Example. Program on Institutional Management in Higher Education.

    Science.gov (United States)

    Pasquier, Jacques; Sachse, Matthias

    Costing principles are applied to a university by estimating unit costs and their component factors for the university's different inputs, activities, and outputs. The information system used is designed for Fribourg University but could be applicable to other Swiss universities and could serve Switzerland's universities policy. In general, it…

  19. Groundwater and stream response times to fertility management changes in pastures

    Science.gov (United States)

    To assess the effectiveness of best-management practices (BMPs), measurements need to be made to determine how the implementation of BMPs affect water quality and soil loss from the areas receiving the practices. For large watersheds (multiple square miles in area) this is a difficult, expensive, a...

  20. Agency costs and income taxation

    Directory of Open Access Journals (Sweden)

    Ulrich Schmidt

    2012-03-01

    Full Text Available This paper analyzes agency costs and the moral hazard problem in the presence of income taxation. As basic framework, income taxes are integrated in the hidden action model of agency theory. In the case of symmetric information no agency costs occur, i.e. optimal risk-sharing can be achieved, if and only if the tax is proportional. It is well-known that asymmetric information causes a welfare loss, termed agency costs, even if no taxes are imposed. Introducing a proportional income tax now increases (decreases these agency costs if the agent exhibits decreasing (increasing absolute risk aversion. Additionally, we show that non-proportional taxes cause higher (lower agency costs than a proportional tax if the agent’s marginal tax rate exceeds (is smaller than the marginal tax rate of the principal.

  1. What can we learn from international comparisons of costs by DRG?

    Science.gov (United States)

    Pirson, M; Schenker, L; Martins, D; Dung, Duong; Chalé, J J; Leclercq, P

    2013-02-01

    The objective of this study was to compare costs data by diagnosis related group (DRG) between Belgium and Switzerland. Our hypotheses were that differences between countries can probably be explained by methodological differences in cost calculations, by differences in medical practices and by differences in cost structures within the two countries. Classifications of DRG used in the two countries differ (AP-DRGs version 1.7 in Switzerland and APR-DRGs version 15.0 in Belgium). The first step of this study was to transform Belgian summaries into Swiss AP-DRGs. Belgian and Swiss data were calculated with a clinical costing methodology (full costing). Belgian and Swiss costs were converted into US$ PPP (purchasing power parity) in order to neutralize differences in purchasing power between countries. The results of this study showed higher costs in Switzerland despite standardization of cost data according to PPP. The difference is not explained by the case-mix index because this was similar for inliers between the two countries. The length of stay (LOS) was also quite similar for inliers between the two countries. The case-mix index was, however, higher for high outliers in Belgium, as reflected in a higher LOS for these patients. Higher costs in Switzerland are thus probably explained mainly by the higher number of agency staff by service in this country or because of differences in medical practices. It is possible to make international comparisons but only if there is standardization of the case-mix between countries and only if comparable accountancy methodologies are used. Harmonization of DRGs groups, nomenclature and accountancy is thus required.

  2. 45 CFR 74.27 - Allowable costs.

    Science.gov (United States)

    2010-10-01

    ... FOR AWARDS AND SUBAWARDS TO INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NONPROFIT ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 74.27... Organizations” and paragraph (b) of this section. The allowability of costs incurred by institutions of higher...

  3. 22 CFR 145.27 - Allowable costs.

    Science.gov (United States)

    2010-04-01

    ... Relations DEPARTMENT OF STATE CIVIL RIGHTS GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 145...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

  4. 38 CFR 49.27 - Allowable costs.

    Science.gov (United States)

    2010-07-01

    ... ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 49.27 Allowable...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

  5. 40 CFR 30.27 - Allowable costs.

    Science.gov (United States)

    2010-07-01

    ... ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 30.27 Allowable...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is...

  6. [The role of Smads and related transcription factors in the signal transduction of bone morphogenetic protein inducing bone formation].

    Science.gov (United States)

    Xu, Xiao-liang; Dai, Ke-rong; Tang, Ting-ting

    2003-09-01

    To clarify the mechanisms of the signal transduction of bone morphogenetic proteins (BMPs) inducing bone formation and to provide theoretical basis for basic and applying research of BMPs. We looked up the literature of the role of Smads and related transcription factors in the signal transduction of BMPs inducing bone formation. The signal transduction processes of BMPs included: 1. BMPs combined with type II and type I receptors; 2. the type I receptor phosphorylated Smads; and 3. Smads entered the cell nucleus, interacted with transcription factors and influenced the transcription of related proteins. Smads could be divided into receptor-regulated Smads (R-Smads: Smad1, Smad2, Smad3, Smad5, Smad8 and Smad9), common-mediator Smad (co-Smad: Smad4), and inhibitory Smads (I-Smads: Smad6 and Smad7). Smad1, Smad5, Smad8, and probable Smad9 were involved in the signal transduction of BMPs. Multiple kinases, such as focal adhesion kinase (FAK), Ras-extracellular signal-regulated kinase (ERK), phosphatidylinositol 3-kinase (PI3K), and Akt serine/threonine kinase were related to Smads signal transduction. Smad1 and Smad5 related with transcription factors included core binding factor A1 (CBFA1), smad-interacting protein 1 (SIP1), ornithine decarboxylase antizyme (OAZ), activating protein-1 (AP-1), xenopus ventralizing homeobox protein-2 (Xvent-2), sandostatin (Ski), antiproliferative proteins (Tob), and homeodomain-containing transcriptian factor-8 (Hoxc-8), et al. CBFA1 could interact with Smad1, Smad2, Smad3, and Smad5, so it was involved in TGF-beta and BMP-2 signal transduction, and played an important role in the bone formation. Cleidocranial dysplasia (CCD) was thought to be caused by heterozygous mutations in CBFA1. The CBFA1 knockout mice showed no osteogenesis and had maturational disturbance of chondrocytes. Smads and related transcription factors, especially Smad1, Smad5, Smad8 and CBFA1, play an important role in the signal transduction of BMPs inducing bone

  7. A review on effectiveness of best management practices in improving hydrology and water quality: Needs and opportunities.

    Science.gov (United States)

    Liu, Yaoze; Engel, Bernard A; Flanagan, Dennis C; Gitau, Margaret W; McMillan, Sara K; Chaubey, Indrajeet

    2017-12-01

    Best management practices (BMPs) have been widely used to address hydrology and water quality issues in both agricultural and urban areas. Increasing numbers of BMPs have been studied in research projects and implemented in watershed management projects, but a gap remains in quantifying their effectiveness through time. In this paper, we review the current knowledge about BMP efficiencies, which indicates that most empirical studies have focused on short-term efficiencies, while few have explored long-term efficiencies. Most simulation efforts that consider BMPs assume constant performance irrespective of ages of the practices, generally based on anticipated maintenance activities or the expected performance over the life of the BMP(s). However, efficiencies of BMPs likely change over time irrespective of maintenance due to factors such as degradation of structures and accumulation of pollutants. Generally, the impacts of BMPs implemented in water quality protection programs at watershed levels have not been as rapid or large as expected, possibly due to overly high expectations for practice long-term efficiency, with BMPs even being sources of pollutants under some conditions and during some time periods. The review of available datasets reveals that current data are limited regarding both short-term and long-term BMP efficiency. Based on this review, this paper provides suggestions regarding needs and opportunities. Existing practice efficiency data need to be compiled. New data on BMP efficiencies that consider important factors, such as maintenance activities, also need to be collected. Then, the existing and new data need to be analyzed. Further research is needed to create a framework, as well as modeling approaches built on the framework, to simulate changes in BMP efficiencies with time. The research community needs to work together in addressing these needs and opportunities, which will assist decision makers in formulating better decisions regarding BMP

  8. Smoking Cessation Is Associated With Lower Indirect Costs.

    Science.gov (United States)

    Baker, Christine L; Bruno, Marianna; Emir, Birol; Li, Vicky W; Goren, Amir

    2018-06-01

    This study quantified differences in indirect costs due to decreased work productivity between current and former smokers. Former smokers were further categorized by number of years since quitting to assess corresponding differences. Data on employed individuals were obtained from the 2013 US National Health and Wellness Survey (NHWS; N = 75,000). Indirect costs were calculated for current smokers and former smokers from weekly wages based on age and sex. The annual total indirect costs for current smokers were $1327.53, $1560.18, and $1839.87 higher than for those who quit 0 to 4 years, 5 to 10 years, and more than or equal to 11 years prior, respectively. There were no significant differences in mean total indirect costs between the former smoker groups. Current smokers showed significantly higher total annual indirect costs compared with former smokers, independently of the number of years since quitting smoking.

  9. International differences in wage and nonwage labor costs

    OpenAIRE

    Riveros, Luis A.

    1989-01-01

    The ratio of nonwage labor costs (for social security, pensions, vacation days, severence compensation, and the like) to direct wage costs is proportionately higher in Europe and Latin America than in Asia and Africa - largely because workers there are protected more by regulations. The distortionary growth of labor costs because of increasing nonwage costs is not common in the LDCs however. The author of this paper found that international differences in labor costs are attributable largely ...

  10. Changing Public Perceptions of Higher Ed

    Science.gov (United States)

    Harney, John O.

    2018-01-01

    The benefits of going to college and the importance of higher education institutions were once held to be a creed as American as apple pie. But recurring state budget challenges have constrained investment. Consistently rising tuitions--fueled by increasing college costs--have alarmed many. Politics and free-speech controversies have raised…

  11. Cost Conscious: Incentive and Discount Programs Help Students Meet the Rising Cost of a Community College Education

    Science.gov (United States)

    Ullman, Ellen

    2013-01-01

    Aware that rising costs could force some community colleges to compromise their long-standing open-door policies, administrators have put in place programs and incentives to offset the higher price of the average community college education. This article features ideas and programs to help struggling community colleges cope with rising costs such…

  12. The burden of pediatric diarrhea: a cross-sectional study of incurred costs and perceptions of cost among Bolivian families.

    Science.gov (United States)

    Burke, Rachel M; Rebolledo, Paulina A; Embrey, Sally R; Wagner, Laura Danielle; Cowden, Carter L; Kelly, Fiona M; Smith, Emily R; Iñiguez, Volga; Leon, Juan S

    2013-08-02

    Worldwide, acute gastroenteritis represents an enormous public health threat to children under five years of age, causing one billion episodes and 1.9 to 3.2 million deaths per year. In Bolivia, which has one of the lower GDPs in South America, an estimated 15% of under-five deaths are caused by diarrhea. Bolivian caregiver expenses related to diarrhea are believed to be minimal, as citizens benefit from universal health insurance for children under five. The goals of this report were to describe total incurred costs and cost burden associated with caregivers seeking treatment for pediatric gastroenteritis, and to quantify relationships among costs, cost burden, treatment setting, and perceptions of costs. From 2007 to 2009, researchers interviewed caregivers (n=1,107) of pediatric patients (costs (e.g. medication, consult fees) and indirect costs (e.g. lost wages). Patient populations were similar across cities in terms of gender, duration of illness, and age, but familial income varied significantly (pcosts to families were significantly higher for inpatients as compared to outpatients of urban (pcosts made up a large proportion of total costs. Forty-five percent of patients' families paid ≥1% of their annual household income for this single diarrheal episode. The perception that cost was affecting family finances was more frequent among those with higher actual cost burden. This study demonstrated that indirect costs due to acute pediatric diarrhea were a large component of total incurred familial costs. Additionally, familial costs associated with a single diarrheal episode affected the actual and perceived financial situation of a large number of caregivers. These data serve as a baseline for societal diarrheal costs before and immediately following the implementation of the rotavirus vaccine and highlight the serious economic importance of a diarrheal episode to Bolivian caregivers.

  13. Effectiveness of best management practices for sediment reduction at operation forest stream crossings

    Science.gov (United States)

    Laura R. Wear; Michael W. Aust; M. Chad Bolding; Brian D. Strahm; C. Andrew Dolloff

    2013-01-01

    Temporary skid trail stream crossings have repeatedly been identified as having considerable potential to introduce sediment to streams. Forestry Best Management Practices (BMPs) have proven to be effective for controlling erosion and subsequent sedimentation, yet few studies have quantified sedimentation associated with various levels of BMPs for skidder stream...

  14. The Influence of Perceptions of Practice Characteristics: An Examination of Agricultural Best Management Practice Adoption in Two Indiana Watersheds

    Science.gov (United States)

    Reimer, Adam P.; Weinkauf, Denise Klotthor; Prokopy, Linda Stalker

    2012-01-01

    Agricultural best management practices (BMPs), or conservation practices, can help reduce nonpoint source pollution from agricultural lands, as well as provide valuable wildlife habitat. There is a large literature exploring factors that lead to a producer's voluntary adoption of BMPs, but there have been inconsistent findings. Generally, this…

  15. Melanoma costs: a dynamic model comparing estimated overall costs of various clinical stages.

    Science.gov (United States)

    Alexandrescu, Doru Traian

    2009-11-15

    The rapidly increasing incidence of melanoma occurs at the same time as an increase in general healthcare costs, particularly the expenses associated with cancer care. Previous cost estimates in melanoma have not utilized a dynamic model considering the evolution of the disease and have not integrated the multiple costs associated with different aspects of medical interventions and patient-related factors. Futhermore, previous calculations have not been updated to reflect the modern tendencies in healthcare costs. We designed a comprehensive model of expenses in melanoma that considers the dynamic costs generated by the natural progression of the disease, which produces costs associated with treatment, surveillance, loss of income, and terminal care. The complete range of initial clinical (TNM) stages of the disease and initial tumor stages were analyzed in this model and the total healthcare costs for the five years following melanoma presentation at each particular stage were calculated. We have observed dramatic incremental total costs associated with progressively higher initial stages of the disease, ranging from a total of $4,648.48 for in situ tumors to $159,808.17 for Stage IV melanoma. By stage, early lesions associate 30-55 percent of their costs for the treatment of the primary tumor, due to a low rate of recurrence (local, regional, or distant), which limits the need for additional interventions. For in situ melanoma, T1a, and T1b, surveillance is an important contributor to the medical costs, accounting for more than 25 percent of the total cost over 5 years. In contrast, late lesions incur a much larger proportion of their associated costs (up to 80-85%) from the diagnosis and treatment of metastatic disease because of the increased propensity of those lesions to disseminate. This cost increases with increasing tumor stage (from $2,442.17 for T1a to $6,678.00 for T4b). The most expensive items in the medical care of patients with melanoma consist of

  16. Association of antipsychotic polypharmacy with health service cost: a register-based cost analysis

    DEFF Research Database (Denmark)

    Baandrup, Lone; Sørensen, Jan; Lublin, Henrik Kai Francis

    2012-01-01

    at the two cross-sectional dates was recorded and used as proxy of polypharmacy exposure during the preceding year. A multivariate generalised linear model was fitted with total costs of primary and secondary health service use as dependent variable, and antipsychotic polypharmacy, diagnosis, age, gender......, disease duration, psychiatric inpatient admissions, and treatment site as covariates. RESULTS: The sample consisted of 736 outpatients with a diagnosis in the schizophrenia spectrum. Antipsychotic polypharmacy was associated with significantly higher total health service costs compared with monotherapy...

  17. Development of a low-cost biogas filtration system to achieve higher-power efficient AC generator

    Science.gov (United States)

    Mojica, Edison E.; Ardaniel, Ar-Ar S.; Leguid, Jeanlou G.; Loyola, Andrea T.

    2018-02-01

    The paper focuses on the development of a low-cost biogas filtration system for alternating current generator to achieve higher efficiency in terms of power production. A raw biogas energy comprises of 57% combustible element and 43% non-combustible elements containing carbon dioxide (36%), water vapor (5%), hydrogen sulfide (0.5%), nitrogen (1%), oxygen (0 - 2%), and ammonia (0 - 1%). The filtration system composes of six stages: stage 1 is the water scrubber filter intended to remove the carbon dioxide and traces of hydrogen sulfide; stage 2 is the silica gel filter intended to reduce the water vapor; stage 3 is the iron sponge filter intended to remove the remaining hydrogen sulfide; stage 4 is the sodium hydroxide solution filter intended to remove the elemental sulfur formed during the interaction of the hydrogen sulfide and the iron sponge and for further removal of carbon dioxide; stage 5 is the silica gel filter intended to further eliminate the water vapor gained in stage 4; and, stage 6 is the activated carbon filter intended to remove the carbon dioxide. The filtration system was able to lower the non-combustible elements by 72% and thus, increasing the combustible element by 54.38%. The unfiltered biogas is capable of generating 16.3 kW while the filtered biogas is capable of generating 18.6 kW. The increased in methane concentration resulted to 14.11% increase in the power output. The outcome resulted to better engine performance in the generation of electricity.

  18. Large-scale performance and design for construction activity erosion control best management practices.

    Science.gov (United States)

    Faucette, L B; Scholl, B; Beighley, R E; Governo, J

    2009-01-01

    The National Pollutant Discharge Elimination System (NPDES) Phase II requires construction activities to have erosion and sediment control best management practices (BMPs) designed and installed for site storm water management. Although BMPs are specified on storm water pollution prevention plans (SWPPPs) as part of the construction general permit (GP), there is little evidence in the research literature as to how BMPs perform or should be designed. The objectives of this study were to: (i) comparatively evaluate the performance of common construction activity erosion control BMPs under a standardized test method, (ii) evaluate the performance of compost erosion control blanket thickness, (iii) evaluate the performance of compost erosion control blankets (CECBs) on a variety of slope angles, and (iv) determine Universal Soil Loss Equation (USLE) cover management factors (C factors) for these BMPs to assist site designers and engineers. Twenty-three erosion control BMPs were evaluated using American Society of Testing and Materials (ASTM) D-6459, standard test method for determination of ECB performance in protecting hill slopes from rainfall induced erosion, on 4:1 (H:V), 3:1, and 2:1 slopes. Soil loss reduction for treatments exposed to 5 cm of rainfall on a 2:1 slope ranged from-7 to 99%. For rainfall exposure of 10 cm, treatment soil loss reduction ranged from 8 to 99%. The 2.5 and 5 cm CECBs significantly reduced erosion on slopes up to 2:1, while CECBs or= 4:1 when rainfall totals reach 5 cm. Based on the soil loss results, USLE C factors ranged from 0.01 to 0.9. These performance and design criteria should aid site planners and designers in decision-making processes.

  19. Form-deprivation myopia induces decreased expression of bone morphogenetic protein-2, 5 in guinea pig sclera

    Directory of Open Access Journals (Sweden)

    Qing Wang

    2015-02-01

    Full Text Available AIM: To identify the presence of various bone morphogenetic proteins (BMPs and their receptors in normal sclera of human, rat and guinea pigs, and to determine whether their expression changed with form-deprivation myopia (FDM in guinea pig sclera. METHODS: The expression of BMPs and BMP receptors were detected using reverse transcription polymerase chain reaction (RT-PCR and immunofluorescence. Two-week-old guinea pigs were monocularly form-deprived with a translucent lens. After fourteen days induction of FDM, total RNA was isolated and subjected to RT-PCR to examine the changes of BMPs and BMP receptors in tissues from the posterior sclera. Western blotting analysis was used to investigate their changes in protein levels. RESULTS: Human sclera expressed mRNAs for BMP-2, -4, -5, -7, -RIA, -RIB and BMP-RII. Conversely, rat sclera only expressed mRNA for BMP-7 and BMP-RIB, while the expression of BMPs and BMP receptors in guinea pigs were similar to that of humans. Human sclera also expresses BMP-2, -4, -5,-7 in protein level. Fourteen days after the induction of myopia, significant decreased expressions for BMP-2 and BMP-5 in the posterior sclera of FDM-affected eyes (PCONCLUSION: Various BMPs were expressed in human and guinea pig sclera. In the posterior sclera, expressions of BMP-2 and BMP-5 significantly decreased in FDM eyes. This finding indicates that various BMPs as components of the scleral cytokines regulating tissue homeostasis and provide evidence that alterations in the expression of BMP-2 and BMP-5 are associated with sclera remodeling during myopia induction.

  20. Cost Economies in the Provision of Higher Education for International Students: Australian Evidence

    Science.gov (United States)

    Zhang, Liang-Cheng; Worthington, Andrew C.; Hu, Mingyan

    2017-01-01

    In the past few decades, the additional revenues available via higher education exports (through both relatively higher prices and increased enrolments) have attracted the attention of providers in many developed countries, not least in Anglophone countries like the USA, the UK, Canada and Australia. However, while the revenue case is strong, the…

  1. Cost per remission and cost per response with infliximab, adalimumab, and golimumab for the treatment of moderately-to-severely active ulcerative colitis.

    Science.gov (United States)

    Toor, Kabirraaj; Druyts, Eric; Jansen, Jeroen P; Thorlund, Kristian

    2015-06-01

    To determine the short-term costs per sustained remission and sustained response of three tumor necrosis factor inhibitors (infliximab, adalimumab, and golimumab) in comparison to conventional therapy for the treatment of moderately-to-severely active ulcerative colitis. A probabilistic Markov model was developed. This included an 8-week induction period, and 22 subsequent 2-week cycles (up to 1 year). The model included three disease states: remission, response, and relapse. Costs were from a Canadian public payer perspective. Estimates for the additional cost per 1 year of sustained remission and sustained response were obtained. Golimumab 100 mg provided the lowest cost per additional remission ($935) and cost per additional response ($701) compared with conventional therapy. Golimumab 50 mg yielded slightly higher costs than golimumab 100 mg. Infliximab was associated with the largest additional number of estimated remissions and responses, but also higher cost at $1975 per remission and $1311 per response. Adalimumab was associated with the largest cost per remission ($7430) and cost per response ($2361). The cost per additional remission and cost per additional response associated with infliximab vs golimumab 100 mg was $14,659 and $4753, respectively. The results suggest that the additional cost of 1 full year of remission and response are lowest with golimumab 100 mg, followed by golimumab 50 mg. Although infliximab has the highest efficacy, it did not exhibit the lowest cost per additional remission or response. Adalimumab produced the highest cost per additional remission and response.

  2. The unit cost factors and calculation methods for decommissioning - Cost estimation of nuclear research facilities

    International Nuclear Information System (INIS)

    Kwan-Seong Jeong; Dong-Gyu Lee; Chong-Hun Jung; Kune-Woo Lee

    2007-01-01

    Available in abstract form only. Full text of publication follows: The uncertainties of decommissioning costs increase high due to several conditions. Decommissioning cost estimation depends on the complexity of nuclear installations, its site-specific physical and radiological inventories. Therefore, the decommissioning costs of nuclear research facilities must be estimated in accordance with the detailed sub-tasks and resources by the tasks of decommissioning activities. By selecting the classified activities and resources, costs are calculated by the items and then the total costs of all decommissioning activities are reshuffled to match with its usage and objectives. And the decommissioning cost of nuclear research facilities is calculated by applying a unit cost factor method on which classification of decommissioning works fitted with the features and specifications of decommissioning objects and establishment of composition factors are based. Decommissioning costs of nuclear research facilities are composed of labor cost, equipment and materials cost. Of these three categorical costs, the calculation of labor costs are very important because decommissioning activities mainly depend on labor force. Labor costs in decommissioning activities are calculated on the basis of working time consumed in decommissioning objects and works. The working times are figured out of unit cost factors and work difficulty factors. Finally, labor costs are figured out by using these factors as parameters of calculation. The accuracy of decommissioning cost estimation results is much higher compared to the real decommissioning works. (authors)

  3. Health insurance, cost expectations, and adverse job turnover.

    Science.gov (United States)

    Ellis, Randall P; Albert Ma, Ching-To

    2011-01-01

    Because less healthy employees value health insurance more than the healthy ones, when health insurance is newly offered job turnover rates for healthier employees decline less than turnover rates for the less healthy. We call this adverse job turnover, and it implies that a firm's expected health costs will increase when health insurance is first offered. Health insurance premiums may fail to adjust sufficiently fast because state regulations restrict annual premium changes, or insurers are reluctant to change premiums rapidly. Even with premiums set at the long run expected costs, some firms may be charged premiums higher than their current expected costs and choose not to offer insurance. High administrative costs at small firms exacerbate this dynamic selection problem. Using 1998-1999 MEDSTAT MarketScan and 1997 Employer Health Insurance Survey data, we find that expected employee health expenditures at firms that offer insurance have lower within-firm and higher between-firm variance than at firms that do not. Turnover rates are systematically higher in industries in which firms are less likely to offer insurance. Simulations of the offer decision capturing between-firm health-cost heterogeneity and expected turnover rates match the observed pattern across firm sizes well. 2010 John Wiley & Sons, Ltd.

  4. Developing a Cost Model and Methodology to Estimate Capital Costs for Thermal Energy Storage

    Energy Technology Data Exchange (ETDEWEB)

    Glatzmaier, G.

    2011-12-01

    This report provides an update on the previous cost model for thermal energy storage (TES) systems. The update allows NREL to estimate the costs of such systems that are compatible with the higher operating temperatures associated with advanced power cycles. The goal of the Department of Energy (DOE) Solar Energy Technology Program is to develop solar technologies that can make a significant contribution to the United States domestic energy supply. The recent DOE SunShot Initiative sets a very aggressive cost goal to reach a Levelized Cost of Energy (LCOE) of 6 cents/kWh by 2020 with no incentives or credits for all solar-to-electricity technologies.1 As this goal is reached, the share of utility power generation that is provided by renewable energy sources is expected to increase dramatically. Because Concentrating Solar Power (CSP) is currently the only renewable technology that is capable of integrating cost-effective energy storage, it is positioned to play a key role in providing renewable, dispatchable power to utilities as the share of power generation from renewable sources increases. Because of this role, future CSP plants will likely have as much as 15 hours of Thermal Energy Storage (TES) included in their design and operation. As such, the cost and performance of the TES system is critical to meeting the SunShot goal for solar technologies. The cost of electricity from a CSP plant depends strongly on its overall efficiency, which is a product of two components - the collection and conversion efficiencies. The collection efficiency determines the portion of incident solar energy that is captured as high-temperature thermal energy. The conversion efficiency determines the portion of thermal energy that is converted to electricity. The operating temperature at which the overall efficiency reaches its maximum depends on many factors, including material properties of the CSP plant components. Increasing the operating temperature of the power generation

  5. The operating cost of electrocoagulation

    Energy Technology Data Exchange (ETDEWEB)

    Donini, J.C.; Kan, J.; Szynkarczuk, J.; Hassan, T.A.; Kar, K.L. (Canadian Centre for Mineral and Energy Technology, Devon, AB (Canada))

    1994-12-01

    The electrocoagulation of kaolinite and bentonite suspensions was studied in a pilot-scale electrocoagulation system to assess the operating cost and efficiency of the process. Factors affecting the operating cost such as formation of passivation layers on electrode plates, flow velocity, and concentration of NaCl in the suspension were examined. The operating costs investigated were the power cost of the electrocoagulation cell and the material cost due to the consumption of the aluminum electrode. Comparison was based on the settling properties of the treated product: turbidity, settling rate, and cake height. Higher NaCl concentration resulted in greater amounts of Al dissolved chemically and electrochemically into the suspension and thus a better clarity of the supernatant of the treated product. Increased flow velocity could reduce significantly the operating cost while improving both clarity of the supernatant and compactness of the sludge volume. The passivation layers developed quickly with time during the electrocoagulation process and more energy became wasted on the layers. 10 refs., 12 figs.

  6. Globalization and the Emergence of For-Profit Higher Education

    Science.gov (United States)

    Morey, Ann I.

    2004-01-01

    Globalization and the revolution in technological communications are major forces of change in higher education. This environment, when coupled with the needs of adult learners and the rising costs of tuition at traditional colleges and universities, has stimulated the emergence of for-profit, degree-granting higher education in the United States.…

  7. Cost estimates for nuclear power in the UK

    International Nuclear Information System (INIS)

    Harris, Grant; Heptonstall, Phil; Gross, Robert; Handley, David

    2013-01-01

    Current UK Government support for nuclear power has in part been informed by cost estimates that suggest that electricity from new nuclear power stations will be competitive with alternative low carbon generation options. The evidence and analysis presented in this paper suggests that the capital cost estimates for nuclear power that are being used to inform these projections rely on costs escalating over the pre-construction and construction phase of the new build programme at a level significantly below those that have been experienced by past US and European programmes. This paper applies observed construction time and cost escalation rates to the published estimates of capital costs for new nuclear plant in the UK and calculates the potential impact on levelised cost per unit of electricity produced. The results suggest that levelised cost may turn out to be significantly higher than expected which in turn has important implications for policy, both in general terms of the potential costs to consumers and more specifically for negotiations around the level of policy support and contractual arrangements offered to individual projects through the proposed contract for difference strike price. -- Highlights: •Nuclear power projects costs can rise substantially during the construction period. •Pre-construction and construction time can be much longer than anticipated. •Adjusting estimates for observed experience increases levelised costs significantly. •Higher costs suggest that more policy support than envisaged may be required

  8. Production of solidified high level wastes: a cost comparison of solidification processes

    International Nuclear Information System (INIS)

    1977-06-01

    Differential cost estimates of the annual operating and maintenance costs and the capital costs for five HLW Waste Solidification Alternates were developed. The annual operating and maintenance cost estimates included the cost of labor, consumables, utilities, shipping casks, shipping and disposal at a federal repository. The capital cost included the cost of the component, installation and building. The differential cost estimates do not include equipment and facilities which are either shared with the reprocessing facility or are common between all of the alternates. Total annual cost differential between the five waste form alternates is summarized in tabular form. The Borosilicate Glass Alternate has the lowest total annual cost. The other alternates have higher costs which range from $6.6 M to $7.4 M per year higher than the Glass alternate with the Supercalcine being the highest cost at $7.4 M per year differential. The major items in the cost estimates are then disposal costs in the operating cost estimates and the HLW Storage Tanks in the capital cost estimates. The Supercalcine Multibarrier Alternate ships 180 canisters per year more than the other alternates and consequently has a significantly higher operating cost. However, off-setting this the Supercalcine Multibarrier Alternate does not require HLW Storage Tanks for decay because of the high heat conductivity of this product and correspondingly the capital cost for this alternate is significantly lower than the other alternates. The radiological risk values are correlated with the cost evaluation normalized to cost ($)/MWe-yr

  9. Integrated watershed- and farm-scale modeling framework for targeting critical source areas while maintaining farm economic viability.

    Science.gov (United States)

    Ghebremichael, Lula T; Veith, Tamie L; Hamlett, James M

    2013-01-15

    environmental mitigation at the farm- and watershed-levels. This paper also outlines steps needed to extract important CSA-related information from a watershed model to help inform targeting decisions at the farm scale. The modeling framework is demonstrated with two unique case studies in the northeastern United States (New York and Vermont), with supporting data from numerous published, location-specific studies at both the watershed and farm scales. Using the integrated modeling framework, it can be possible to compare the costs (in terms of changes required in farm system components or financial compensations for retiring crop lands) and benefits (in terms of measurable water quality improvement goals) of implementing targeted BMPs. This multi-scale modeling approach can be used in the multi-objective task of mitigating CSAs of pollution to meet water quality goals while maintaining farm-level economic viability. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. 7 CFR 3015.195 - Subgrants and cost-type contracts.

    Science.gov (United States)

    2010-01-01

    ...-21 would apply to the costs incurred by the institution of higher education even though OMB Circular A-87 would apply to the costs incurred by the State. ... 7 Agriculture 15 2010-01-01 2010-01-01 false Subgrants and cost-type contracts. 3015.195 Section...

  11. British Asian Women and the Costs of Higher Education in England

    Science.gov (United States)

    Bhopal, Kalwant

    2016-01-01

    This article will examine Asian women's experiences of financial support in higher education. The article is based on 30 in-depth interviews with Asian women who were studying at a "new" (post-1992) university in the South East of England. Women identified themselves as Muslim, Hindu and Sikh. The findings reveal that women's religious…

  12. 22 CFR 518.27 - Allowable costs.

    Science.gov (United States)

    2010-04-01

    ... INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 518.27 Allowable costs. For each kind of recipient, there is a set of... by institutions of higher education is determined in accordance with the provisions of OMB Circular A...

  13. Cost comparison of open and robotic partial nephrectomy using a short postoperative pathway.

    Science.gov (United States)

    Mano, Roy; Schulman, Ariel; Hakimi, A Ari; Sternberg, Itay A; Bernstein, Melanie; Bochner, Bernard H; Coleman, Jonathan A; Russo, Paul

    2015-03-01

    To compare immediate perioperative direct costs of open partial nephrectomy (OPN) and robotic partial nephrectomy (RPN), managed under a common care pathway. Retrospective review of detailed institutional cost data for patients treated with OPN and RPN during 2011 was conducted. Cost and clinical data of OPN and RPN were compared for all patients and for patients stratified by length of stay (LOS), American Society of Anesthesiologists (ASA), and RENAL nephrometry scores. The study cohort included 190 OPN and 63 RPN cases. OPN was associated with higher ASA scores (P days (2-3 days) for OPN compared with 1 day (1-2 days) for RPN (P cost of OPN was lower than that of RPN with a difference of $3091 (P costs were higher in OPN, surgical costs were higher in RPN ($854 and $3695 difference in median costs, respectively; P cost of OPN for patients with an above-average LOS remained lower than that of RPN ($2680 difference in median costs; P = .001). RPN costs remained significantly higher when stratifying patients by their ASA and RENAL nephrometry scores. Despite the shorter hospital LOS associated with RPN, the immediate perioperative cost of OPN was lower than that of RPN for patients managed under a common care pathway, mainly due to high robotic purchase and maintenance costs. In light of the current health care debate, such financial disincentives may compromise the sustainability of advances in medical technology. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Intervariability and intravariability of bone morphogenetic proteins in commercially available demineralized bone matrix products.

    Science.gov (United States)

    Bae, Hyun W; Zhao, Li; Kanim, Linda E A; Wong, Pamela; Delamarter, Rick B; Dawson, Edgar G

    2006-05-20

    Enzyme-linked immunosorbent assay was used to detect bone morphogenetic proteins (BMPs) 2, 4, and 7 in 9 commercially available ("off the shelf") demineralized bone matrix (DBM) product formulations using 3 different manufacturer's production lots of each DBM formulation. To evaluate and compare the quantity of BMPs among several different DBM formulations (inter-product variability), as well as examine the variability of these proteins in different production lots within the same DBM formulation (intra-product variability). DBMs are commonly used to augment available bone graft in spinal fusion procedures. Surgeons are presented with an ever-increasing variety of commercially available human DBMs from which to choose. Yet, there is limited information on a specific DBM product's osteoinductive efficacy, potency, and constancy. There were protein extracts from each DBM sample separately dialyzed 4 times against distilled water at 4 degrees C for 48 hours. The amount of BMP-2, BMP-4, and BMP-7 was determined using enzyme-linked immunosorbent assay. RESULTS.: The concentrations of detected BMP-2 and BMP-7 were low for all DBM formulations, only nanograms of BMP were extracted from each gram of DBM (20.2-120.6 ng BMP-2/g DBM product; 54.2-226.8 ng BMP-7/g DBM). The variability of BMP concentrations among different lots of the same DBM formulation, intra-product variability, was higher than the variability of concentrations among different DBM formulations, inter-product variability (coefficient of variation range BMP-2 [16.34% to 76.01%], P DBMs are low, in the order of 1 x 10(-9) g of BMP/g of DBM. There is higher variability in concentration of BMPs among 3 different lots of the same DBM formulation than among different DBM formulations. This variability questions DBM products' reliability and, possibly, efficacy in providing consistent osteoinduction.

  15. Costs of day hospital and community residential chemical dependency treatment.

    Science.gov (United States)

    Kaskutas, Lee Ann; Zavala, Silvana K; Parthasarathy, Sujaya; Witbrodt, Jane

    2008-03-01

    Patient placement criteria developed by the American Society of Addiction Medicine (ASAM) have identified a need for low-intensity residential treatment as an alternative to day hospital for patients with higher levels of severity. A recent clinical trial found similar outcomes at social model residential treatment and clinically-oriented day hospital programs, but did not report on costs. This paper addresses whether the similar outcomes in the recent trial were delivered with comparable costs, overall and within gender and ethnicity stratum. This paper reports on clients not at environmental risk who participated in a randomized trial conducted in three metropolitan areas served by a large pre-paid health plan. Cost data were collected using the Drug Abuse Treatment Cost Analysis Program (DATCAP). Costs per episode were calculated by multiplying DATCAP-derived program-specific costs by each client's length of stay. Differences in length of stay, and in per-episode costs, were compared between residential and day hospital subjects. Lengths of stay at residential treatment were significantly longer than at day hospital, in the sample overall and in disaggregated analyses. This difference was especially marked among non-Whites. The average cost per week was USD 575 per week at day hospital, versus USD 370 per week at the residential programs. However, because of the longer stays in residential, per-episode costs were significantly higher in the sample overall and among non-Whites (and marginally higher for men). These cost results must be considered in light of the null findings comparing outcomes between subjects randomized to residential versus day hospital programs. The longer stays in the sample overall and for non-White clients at residential programs came at higher costs but did not lead to better rates of abstinence. The short stays in day hospital among non-Whites call into question the attractiveness of day hospital for minority clients. Outcomes and costs

  16. Societal cost of traumatic brain injury: A comparison of cost-of-injuries related to biking with and without helmet use.

    Science.gov (United States)

    Costa, Camille K; Dagher, Jehane H; Lamoureux, Julie; de Guise, Elaine; Feyz, Mitra

    2015-01-01

    The goal of this study is to determine if a difference in societal costs exists from traumatic brain injuries (TBI) in patients who wear helmets compared to non-wearers. This is a retrospective cost-of-injury study of 128 patients admitted to the Montreal General Hospital (MGH) following a TBI that occurred while cycling between 2007-2011. Information was collected from Quebec Trauma Registry. The independent variables collected were socio-demographic, helmet status, clinical and neurological patient information. The dependent variables evaluated societal costs. The median costs of hospitalization were significantly higher (p = 0.037) in the no helmet group ($7246.67 vs. $4328.17). No differences in costs were found for inpatient rehabilitation (p = 0.525), outpatient rehabilitation (p = 0.192), loss of productivity (p = 0.108) or death (p = 1.000). Overall, the differences in total societal costs between the helmet and no helmet group were not significantly different (p = 0.065). However, the median total costs for patients with isolated TBI in the non-helmet group ($22, 232.82) was significantly higher (p = 0.045) compared to the helmet group ($13, 920.15). Cyclists sustaining TBIs who did not wear helmets in this study were found to cost society nearly double that of helmeted cyclists.

  17. Consideration of higher seismic loads at existing plants

    Energy Technology Data Exchange (ETDEWEB)

    Liebig, J.; Pellissetti, M.

    2015-07-01

    Because of advancement of methods in probabilistic seismic hazard analysis, plenty of existing plants face higher seismic loads as an obligation from the national authorities. In case of such obligations safety related structures and equipment have to be reevaluated or requalified for the increased seismic loads. The paper provides solutions for different kinds of structures and equipment inside the plant, avoiding cost intensive hardware exchange. Due to higher seismic loads different kinds of structures and equipment inside a plant have to be reevaluated. For civil structures, primary components, mechanical components, distribution lines and electrical and I&C equipment different innovative concepts will be applied to keep structures and equipment qualified for the higher seismic loads. Detailed analysis, including the modeling of non-linear phenomena, or minor structural upgrades are cost competitive, compared to cost intensive hardware exchanges. Several case studies regarding the re-evaluation and requalification of structures and equipment due to higher seismic loads are presented. It is shown how the creation of coupled finite element models and the consistent propagation of acceleration time histories through the soil, building and primary circuit lead to a significant load reduction Electrical and I&C equipment is reinforced by smart upgrades which increase the natural equipment frequencies. Therefore for all devices inside the cabinets the local acceleration will not increase and the seismic qualification will be maintained. The case studies cover both classical deterministic and probabilistic re-evaluations (fragility analysis). Furthermore, the substantial benefits of non-linear limit load evaluation, such as push-over analysis of buildings and limit load analysis of fuel assemblies, are demonstrated. (Author)

  18. The availability and cost of healthier food alternatives.

    Science.gov (United States)

    Jetter, Karen M; Cassady, Diana L

    2006-01-01

    Many people, especially low-income consumers, do not successfully follow dietary recommendations to eat more whole grains and less fat and added sugar. The food environment may have a significant impact on the choice by low-income consumers to eat healthier foods, as both the availability and price of healthier food items may limit their ability to eat a healthier diet. We investigated the cost and availability of a standard market basket of foods, and a healthier basket that included low-fat meat and dairy and whole grain products. Market-basket surveys were conducted in 25 stores in Los Angeles and Sacramento. Stores were selected from neighborhoods that were varied by income and surveyed three times from September 2003 to June 2004. The average cost of a standard market basket (based on the U.S. Department of Agriculture's Thrifty Food Plan [TFP]) and a healthier market basket was calculated from these prices and compared using a standard t-test to determine if they were significantly different from each other. The analysis was conducted in 2005. In neighborhoods served by smaller grocery stores, access to whole-grain products, low-fat cheeses, and ground meat with cost was $194, and the healthier market-basket cost was $230. The average cost of the healthier market basket was more expensive by $36 due to higher costs of whole grains, lean ground beef, and skinless poultry. The higher cost of the healthier basket is equal to about 35% to 40% of low-income consumers' food budgets of $2410 a year. The lack of availability in small grocery stores located in low-income neighborhoods, and the higher cost of the healthier market basket may be a deterrent to eating healthier among very low-income consumers. Public policies should take the food environment into account in order to develop successful strategies to encourage the consumption of healthier foods.

  19. Digital vs conventional radiography: cost and revenue analysis

    International Nuclear Information System (INIS)

    Dalla Palma, L.; Cuttin, R.; Rimondini, A.; Grisi, G.

    1999-01-01

    The objective of this study was to analyse and compare the operating and investment costs of two radiographic systems, a conventional and a digital one, and to evaluate the cost/revenue ratio of the two systems. The radiological activity over 1 year for chest and skeletal exams was evaluated: 13,401 chest and 7,124 skeletal exams were considered. The following parameters of variable costs were evaluated: the difference between variable proportional costs of the two technologies, the effective variable cost of any size film, including the chemicals, and for different sizes of digital film, variable costs of chest plus skeletal exams performed with the two techniques. Afterwards the economical effect was considered taking into account depreciation during a time of utilization ranging between 8 and 4 years. In the second part of the analysis the total cost and the revenues of the two technologies were determined. The comparison between the digital and conventional systems has shown the following aspects: 1. Digital radiography system has a much higher investment cost in comparison with the conventional one. 2. Operating costs of digital equipment are higher or lower depending on the film size used. Evaluating chest X-ray we reach a breakeven point after 1 year and 10,000 exams only if displayed over 8 x 10-in. film and after 30,000 if displayed over a 11 x 14-in. film. 3. The total cost (variable cost, technology cost, labour cost) of digital technology is lower than that of the conventional system by 20 % on average using 8 x 10-in. film size. 4. Digital technology also allows lesser film waste and lesser film per exam (orig.)

  20. Fair Access to Higher Education: Global Perspectives

    Science.gov (United States)

    Mountford-Zimdars, Anna, Ed.; Sabbagh, Daniel, Ed.; Post, David, Ed.

    2015-01-01

    What does "fairness" mean internationally in terms of access to higher education? Increased competition for places in elite universities has prompted a worldwide discussion regarding the fairness of student admission policies. Despite budget cuts from governments--and increasing costs for students--competition is fierce at the most…

  1. Shadow Cost of Public Funds and Privatization Policies

    OpenAIRE

    Sato, Susumu; Matsumura, Toshihiro

    2017-01-01

    We investigate the optimal privatization policy in mixed oligopolies with shadow cost of public funds (excess burden of taxation). The government is concerned with both the total social surplus and the revenue obtained by the privatization of a public firm. We find that the relationship between the shadow cost of public funds and the optimal privatization policy is non-monotone. When the cost is moderate, then higher the cost is, the lower is the optimal degree of privatization. ...

  2. Emissions trading and transaction costs : analyzing the flaws in the discussion

    NARCIS (Netherlands)

    Woerdman, E.

    Although emissions trading lowers the costs of climate change mitigation, transaction costs (e.g. to find a trading partner) may reduce its cost-effectiveness. Some economists claim that transaction costs for Joint Implementation (JI) and Clean Development Mechanism (CDM) projects will be higher

  3. Transaction costs and community-based natural resource management in Nepal.

    Science.gov (United States)

    Adhikari, Bhim; Lovett, Jon C

    2006-01-01

    Transaction costs in community-based resource management are incurred by households attempting to enforce property right rules over common resources similar to those inherent in private property rights. Despite their importance, transaction costs of community-based management of common pool resources (CPRs) are often not incorporated into the economic analysis of participatory resource management. This paper examines the transaction costs incurred by forest users in community forestry (CF) based on a survey of 309 households belonging to eight different forest user groups (FUGs) in the mid hills of Nepal. The analysis reveals that the average 'poor' household incurred Nepalese rupees (NRS) 1265 in transaction costs annually, while wealthier 'rich' households incurred an average of NRS 2312 per year. Although richer households bear higher proportions of such costs, transaction costs for CF management as a percentage of resource appropriation costs are higher for poorer households (26%) than those of middle-wealth (24%) or rich households (14%). There are also village differences in the level of transaction costs. The results show that transaction costs are a major component of resource management costs and vary according to socio-economic status of resource users and characteristics of the community.

  4. How does Cash and Counseling affect costs?

    Science.gov (United States)

    Dale, Stacy B; Brown, Randall S

    2007-02-01

    To test the effect of a consumer-directed model (Cash and Counseling) of Medicaid personal care services (PCS) or home- and community-based waiver services (HCBS) on the cost of Medicaid services. Medicaid claims data were collected for all enrollees in the Cash and Counseling demonstration. Demonstration enrollees included those eligible for PCS (in Arkansas), those assessed to receive such services (in New Jersey), and recipients of Medicaid HCBS (in Florida). Enrollment occurred from December 1998 through April 2001. The follow-up period covered up to 24 months after enrollment. Demonstration volunteers were randomly assigned to have the option to participate in Cash and Counseling (the treatment group), or to receive Medicaid services as usual from an agency (the control group). Ordinary least squares regressions were used to estimate the effect of the program on costs for Medicaid PCS/waiver services and other Medicaid services, while controlling for consumers' preenrollment characteristics and preenrollment Medicaid spending. Models were estimated separately for nonelderly and elderly adults in each state and for children in Florida. Each state supplied claims data for demonstration enrollees. Largely because the program increased consumers' ability to get the authorized amount of paid care, expenditures for personal care/waiver services were higher for the treatment group than for the control group in each state and age group, except among the elderly in Florida. Higher costs for personal care/waiver services were partially offset by savings in other Medicaid services, particularly those related to long-term care. During year 1, total Medicaid costs were generally higher for the treatment group than for the control group, with treatment-control cost differences ranging from 1 percent (and statistically insignificant) for the elderly in Florida to 17 percent for the elderly in Arkansas. In year 2, these cost differences were generally greater than in year 1

  5. Damage cost of the Dan River coal ash spill

    International Nuclear Information System (INIS)

    Dennis Lemly, A.

    2015-01-01

    The recent coal ash spill on the Dan River in North Carolina, USA has caused several negative effects on the environment and the public. In this analysis, I report a monetized value for these effects after the first 6 months following the spill. The combined cost of ecological damage, recreational impacts, effects on human health and consumptive use, and esthetic value losses totals $295,485,000. Because the environmental impact and associated economic costs of riverine coal ash spills can be long-term, on the order of years or even decades, this 6-month assessment should be viewed as a short-term preview. The total cumulative damage cost from the Dan River coal ash spill could go much higher. - Highlights: • Six-month post-spill damage cost exceeded $295,000,000. • Components of cost include ecological, recreational, human health, property, and aesthetic values. • Attempts by the electric utility to “clean” the river left over 95% of coal ash behind. • Long-term impacts will likely drive the total damage cost much higher. - Damage costs of the Dan River coal ash spill are extensive and growing. The 6-month cost of that spill is valued at $295,485,000, and the long-term total cost is likely to rise substantially

  6. Costs and outcomes associated with IVF using recombinant FSH.

    Science.gov (United States)

    Ledger, W; Wiebinga, C; Anderson, P; Irwin, D; Holman, A; Lloyd, A

    2009-09-01

    Cost and outcome estimates based on clinical trial data may not reflect usual clinical practice, yet they are often used to inform service provision and budget decisions. To expand understanding of assisted reproduction treatment in clinical practice, an economic evaluation of IVF/intracytoplasmic sperm injection (ICSI) data from a single assisted conception unit (ACU) in England was performed. A total of 1418 IVF/ICSI cycles undertaken there between October 2001 and January 2006 in 1001 women were analysed. The overall live birth rate was 22% (95% CI: 19.7-24.2), with the 30- to 34-year age group achieving the highest rate (28%). The average recombinant FSH (rFSH) dose/cycle prescribed was 1855 IU. Average cost of rFSH/cycle was 646 pound(SD: 219 pound), and average total cost/cycle was 2932 pound (SD: 422 pound). Economic data based on clinical trials informing current UK guidance assumes higher doses of rFSH dose/cycle (1750-2625 IU), higher average cost of drugs/cycle (1179 pound), and higher average total cost/cycle (3266 pound). While the outcomes in this study matched UK averages, total cost/cycle was lower than those cited in UK guidelines. Utilizing the protocols and (lower) rFSH dosages reported in this study may enable other ACU to provide a greater number of IVF/ICSI cycles to patients within given budgets.

  7. Efficiencies of forestry best management practices for reducing sediment and nutrient losses in the eastern United States

    Science.gov (United States)

    Pamela Edwards; Karl W.J. Williard

    2010-01-01

    Quantifying the effects of forestry best management practices (BMPs) on sediment and nutrient loads is a critical need. Through an exhaustive literature search, three paired forested watershed studies in the eastern United States were found that permitted the calculation of BMP efficiencies--the percent reduction in sediment or nutrients achieved by BMPs. For sediment...

  8. Forestry best management practices and sediment control at skidder stream crossings

    Science.gov (United States)

    Laura R. Wear; W. Michael Aust; M. Chad Bolding; Brian D. Strahm; Andrew C. Dolloff

    2015-01-01

    Stream crossings for skid trails have high sediment delivery ratios. Forestry Best Management Practices (BMPs) have proven to be effective for erosion control, but few studies have quantified the impact of various levels of BMPs on sedimentation. In this study, three skid-trail stream-crossing BMP treatments were installed on nine operational stream crossings (three...

  9. Excess costs from functional somatic syndromes in Germany - An analysis using entropy balancing.

    Science.gov (United States)

    Grupp, Helen; Kaufmann, Claudia; König, Hans-Helmut; Bleibler, Florian; Wild, Beate; Szecsenyi, Joachim; Herzog, Wolfgang; Schellberg, Dieter; Schäfert, Rainer; Konnopka, Alexander

    2017-06-01

    The aim of this study was to calculate disorder-specific excess costs in patients with functional somatic syndromes (FSS). We compared 6-month direct and indirect costs in a patient group with FSS (n=273) to a control group of the general adult population in Germany without FSS (n=2914). Data on the patient group were collected between 2007 and 2009 in a randomized controlled trial (speciAL). Data on the control group were obtained from a telephone survey, representative for the general German population, conducted in 2014. Covariate balance between the patient group and the control group was achieved using entropy balancing. Excess costs were calculated by estimating generalized linear models and two-part models for direct costs and indirect costs. Further, we estimated excess costs according to the level of somatic symptom severity (SSS). FSS patients differed significantly from the control group regarding 6-month costs of outpatient physicians (+€280) and other outpatient providers (+€74). According to SSS, significantly higher outpatient physician costs were found for mild (+€151), moderate (+€306) and severe (+€376) SSS. We also found significantly higher costs of other outpatient providers in patients with mild, moderate and severe SSS. Regarding costs of rehabilitation and hospital treatments, FSS patients did not differ significantly from the control group for any level of SSS. Indirect costs were significantly higher in patients with severe SSS (+€760). FSS were of major importance in the outpatient sector. Further, we found significantly higher indirect costs in patients with severe SSS. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Improving building performance using smart building concept: Benefit cost ratio comparison

    Science.gov (United States)

    Berawi, Mohammed Ali; Miraj, Perdana; Sayuti, Mustika Sari; Berawi, Abdur Rohim Boy

    2017-11-01

    Smart building concept is an implementation of technology developed in the construction industry throughout the world. However, the implementation of this concept is still below expectations due to various obstacles such as higher initial cost than a conventional concept and existing regulation siding with the lowest cost in the tender process. This research aims to develop intelligent building concept using value engineering approach to obtain added value regarding quality, efficiency, and innovation. The research combined quantitative and qualitative approach using questionnaire survey and value engineering method to achieve the research objectives. The research output will show additional functions regarding technology innovation that may increase the value of a building. This study shows that smart building concept requires higher initial cost, but produces lower operational and maintenance costs. Furthermore, it also confirms that benefit-cost ratio on the smart building was much higher than a conventional building, that is 1.99 to 0.88.

  11. The cost of obesity for nonbariatric inpatient operative procedures in the United States: national cost estimates obese versus nonobese patients.

    Science.gov (United States)

    Mason, Rodney J; Moroney, Jolene R; Berne, Thomas V

    2013-10-01

    To evaluate the economic impact of obesity on hospital costs associated with the commonest nonbariatric, nonobstetrical surgical procedures. Health care costs and obesity are both rising. Nonsurgical costs associated with obesity are well documented but surgical costs are not. National cost estimates were calculated from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database, 2005-2009, for the highest volume nonbariatric nonobstetric procedures. Obesity was identified from the HCUP-NIS severity data file comorbidity index. Costs for obese patients were compared with those for nonobese patients. To control for medical complexity, each obese patient was matched one-to-one with a nonobese patient using age, sex, race, and 28 comorbid defined elements. Of 2,309,699 procedures, 439,8129 (19%) were successfully matched into 2 medically equal groups (obese vs nonobese). Adjusted total hospital costs incurred by obese patients were 3.7% higher with a significantly (P cost of $648 (95% confidence interval [CI]: $556-$736) compared with nonobese patients. Of the 2 major components of hospital costs, length of stay was significantly increased in obese patients (mean difference = 0.0253 days, 95% CI: 0.0225-0.0282) and resource utilization determined by costs per day were greater in obese patients due to an increased number of diagnostic and therapeutic procedures needed postoperatively (odds ratio [OR] = 0.94, 95% CI: 0.93-0.96). Postoperative complications were equivalent in both groups (OR = 0.97, 95% CI: 0.93-1.02). Annual national hospital expenditures for the largest volume surgical procedures is an estimated $160 million higher in obese than in a comparative group of nonobese patients.

  12. Smoking, depression, and hospital costs of respiratory cancers: Examining race and sex variation

    Directory of Open Access Journals (Sweden)

    Baqar A. Husaini

    2017-05-01

    Full Text Available Objective: To investigate the effect of smoking and depression on hospital costs for lung cancer (LC. Methods: We extracted data on depression, smoking history, demographics, and hospital charges for patients with respiratory cancers (ICD-9 codes 161–163, 165 from the 2008 Tennessee Hospital Discharge Data System. The sample (n=6665 was mostly white (86% and male (57%. Age-adjusted rates were developed in accordance with Centers for Disease Control and Prevention methods, and hospital costs were compared for patients with LC with versus without depression and a smoking history. Results: Three findings (P<0.001 emerged: (1 the LC rate was higher among blacks than among whites, and higher among men than among women; (2 while 66% of LC patients smoked (more men than women without racial variation, 24% had depression (more females and whites were depressed; (3 the LC hospital cost was 54% higher than the non-LC hospital cost, and this cost doubled for patients with LC with depression and smoking versus those without such characteristics. Conclusion: While LC is more prevalent among blacks and men, depression is higher among female and white patients. Since depression with higher costs existed among LC patients, our findings point to (1 the possibility of cost savings by diagnosing and treating depression among LC patients, and (2 implementation of proven smoking cessation programs to reduce LC morbidity and hospital costs.

  13. Economic costs of electricity production in Poland

    International Nuclear Information System (INIS)

    Beeldman, M.; Solinski, J.

    1994-02-01

    This study presents a methodology for the calculation of the economic costs of the production of electricity. This methodology is applied to assess electricity production cost in Poland by type of power station for the years 1995 and 2000. In addition, an overview is presented of the methods used by the OECD countries, particularly in the Netherlands. The main conclusions of the study are: 1) the real economic costs to generate electricity in Poland are about two times higher compared with the traditional book-keeping data; 2) the investment costs will become the most important cost component in the near future; and 3) there are considerables differences in production cost per kWh for the different types of power plants in Poland. 4 appendices, 14 refs

  14. Dynamics of BMP signaling in limb bud mesenchyme and polydactyly.

    Science.gov (United States)

    Norrie, Jacqueline L; Lewandowski, Jordan P; Bouldin, Cortney M; Amarnath, Smita; Li, Qiang; Vokes, Martha S; Ehrlich, Lauren I R; Harfe, Brian D; Vokes, Steven A

    2014-09-15

    Mutations in the Bone Morphogenetic Protein (BMP) pathway are associated with a range of defects in skeletal formation. Genetic analysis of BMP signaling requirements is complicated by the presence of three partially redundant BMPs that are required for multiple stages of limb development. We generated an inducible allele of a BMP inhibitor, Gremlin, which reduces BMP signaling. We show that BMPs act in a dose and time dependent manner in which early reduction of BMPs result in digit loss, while inhibiting overall BMP signaling between E10.5 and E11.5 allows polydactylous digit formation. During this period, inhibiting BMPs extends the duration of FGF signaling. Sox9 is initially expressed in normal digit ray domains but at reduced levels that correlate with the reduction in BMP signaling. The persistence of elevated FGF signaling likely promotes cell proliferation and survival, inhibiting the activation of Sox9 and secondarily, inhibiting the differentiation of Sox9-expressing chondrocytes. Our results provide new insights into the timing and clarify the mechanisms underlying BMP signaling during digit morphogenesis. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Nuclear power investment and generating costs from a utility point of view

    International Nuclear Information System (INIS)

    Roth, B.F.

    1975-01-01

    Nuclear power stations presently in operation in the Federal Republic of Germany have electricity generating costs between 3.5 Pf/kWh and 4.5 Pf/kWh. The higher electricity generating costs are due mainly to the increased expenditure required for the protection of plants against airplane crashes, earthquakes and sabotage, and to the higher costs of the entire fuel cycle. (orig./RW) [de

  16. Managing the higher risks of low-cost high-efficiency advanced power generation technologies

    International Nuclear Information System (INIS)

    Pearson, M.

    1997-01-01

    Independent power producers operate large coal-fired installations and gas turbine combined-cycle (GTCC) facilities. Combined cycle units are complex and their reliability and availability is greatly influenced by mechanical, instrumentation and control weaknesses. It was suggested that these weaknesses could be avoided by tighter specifications and more rigorous functional testing before acceptance by the owner. For the present, the difficulties of developing reliable, lower installed cost/kw, more efficient GTCC designs, pressure for lower NO x emissions with 'dry' combustors continue to be the most difficult challenges for all GT manufacturers

  17. COST MEASUREMENT AND COST MANAGEMENT IN TARGET COSTING

    Directory of Open Access Journals (Sweden)

    Moisello Anna Maria

    2012-07-01

    Full Text Available Firms are coping with a competitive scenario characterized by quick changes produced by internationalization, concentration, restructuring, technological innovation processes and financial market crisis. On the one hand market enlargement have increased the number and the segmentation of customers and have raised the number of competitors, on the other hand technological innovation has reduced product life cycle. So firms have to adjust their management models to this scenario, pursuing customer satisfaction and respecting cost constraints. In a context where price is a variable fixed by the market, firms have to switch from the cost measurement logic to the cost management one, adopting target costing methodology. The target costing process is a price driven, customer oriented profit planning and cost management system. It works, in a cross functional way, from the design stage throughout all the product life cycle and it involves the entire value chain. The process implementation needs a costing methodology consistent with the cost management logic. The aim of the paper is to focus on Activity Based Costing (ABC application to target costing process. So: -it analyzes target costing logic and phases, basing on a literary review, in order to highlight the costing needs related to this process; -it shows, through a numerical example, how to structure a flexible ABC model – characterized by the separation between variable, fixed in the short and fixed costs - that effectively supports target costing process in the cost measurement phase (drifting cost determination and in the target cost alignment; -it points out the effectiveness of the Activity Based Costing as a model of cost measurement applicable to the supplier choice and as a support for supply cost management which have an important role in target costing process. The activity based information allows a firm to optimize the supplier choice by following the method of minimizing the

  18. Proprietary hospitals in cost containment.

    Science.gov (United States)

    Jones, D A

    1985-08-23

    Any effort to control the rise in health care costs must start with analyzing the causes, which are really quite simple. Most cost control efforts fail because they do not address the causes. The causes are large subsidies in several forms that send a false message that health care is free and should be used abundantly, and expansive reimbursement programs that reward inefficient providers with higher payments. This combination of demand stimulation and cost-plus reimbursement produced the world's most expensive health care delivery system and strident calls for reform. A long overdue change in public policy took effect October 1, 1983, when Medicare payments moved from cost-plus reimbursement to fixed, prospectively determined prices. Because it addressed one of the causes of medical inflation, this change has been effective in slowing the rise in Medicare expenditures. Sponsorship of a hospital is not a determinant of its cost-effectiveness. There are examples of efficient and inefficient hospitals in both the voluntary and the investor-owned or taxpaying hospitals. The determining factor is the will of management to keep costs under control.

  19. Real world costs and cost-effectiveness of Rituximab for diffuse large B-cell lymphoma patients: a population-based analysis.

    Science.gov (United States)

    Khor, Sara; Beca, Jaclyn; Krahn, Murray; Hodgson, David; Lee, Linda; Crump, Michael; Bremner, Karen E; Luo, Jin; Mamdani, Muhammad; Bell, Chaim M; Sawka, Carol; Gavura, Scott; Sullivan, Terrence; Trudeau, Maureen; Peacock, Stuart; Hoch, Jeffrey S

    2014-08-12

    Current treatment of diffuse-large-B-cell lymphoma (DLBCL) includes rituximab, an expensive drug, combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy. Economic models have predicted rituximab plus CHOP (RCHOP) to be a cost-effective alternative to CHOP alone as first-line treatment of DLBCL, but it remains unclear what its real-world costs and cost-effectiveness are in routine clinical practice. We performed a population-based retrospective cohort study from 1997 to 2007, using linked administrative databases in Ontario, Canada, to evaluate the costs and cost-effectiveness of RCHOP compared to CHOP alone. A historical control cohort (n = 1,099) with DLBCL who received CHOP before rituximab approval was hard-matched on age and treatment intensity and then propensity-score matched on sex, comorbidity, and histology to 1,099 RCHOP patients. All costs and outcomes were adjusted for censoring using the inverse probability weighting method. The main outcome measure was incremental cost per life-year gained (LYG). Rituximab was associated with a life expectancy increase of 3.2 months over 5 years at an additional cost of $16,298, corresponding to an incremental cost-effectiveness ratio of $61,984 (95% CI $34,087-$135,890) per LYG. The probability of being cost-effective was 90% if the willingness-to-pay threshold was $100,000/LYG. The cost-effectiveness ratio was most favourable for patients less than 60 years old ($31,800/LYG) but increased to $80,600/LYG for patients 60-79 years old and $110,100/LYG for patients ≥ 80 years old. We found that post-market survival benefits of rituximab are similar to or lower than those reported in clinical trials, while the costs, incremental costs and cost-effectiveness ratios are higher than in published economic models and differ by age. Our results showed that the addition of rituximab to standard CHOP chemotherapy was associated with improvement in survival but at a higher cost, and was

  20. Costs of electronuclear fuel production

    International Nuclear Information System (INIS)

    Flaim, T.; Loose, V.

    1978-07-01

    The Los Alamos Scientific Laboratory (LASL) proposes to study the electronuclear fuel producer (EFP) as a means of producing fissile fuel to generate electricity. The main advantage of the EFP is that it may reduce the risks of nuclear proliferation by breeding 233 U from thorium, thereby avoiding plutonium separation. A report on the costs of electronuclear fuel production based upon two designs considered by LASL is presented. The findings indicate that the EFP design variations considered are not likely to result in electricity generation costs as low as the uranium fuel cycle used in the US today. At current estimates of annual fuel output (500 kg 233 U per EFP), the costs of electricity generation using fuel produced by the EFP are more than three times higher than generating costs using the traditional fuel cycle. Sensitivity analysis indicates that electronuclear fuel production would become cost competitive with the traditional uranium fuel cycle when U 3 O 8 (yellowcake) prices approach $1000 per pound

  1. [Cost effectiveness of workplace smoking policies].

    Science.gov (United States)

    Raaijmakers, Tamara; van den Borne, Inge

    2003-01-01

    This study reviews the motivations of companies to set out a policy for controlling smoking, the economic benefits for the company resulting from such a policy and the costs, broken down by European Union countries. The literature on the costs of implementing a policy related to smoking at the workplace is reviewed. The main objective of policies related to smoking at the workplace is that of safeguarding employees from environmental tobacco smoke. Other reasons are cutting costs, improving the company image, and reducing absenteeism, occupational accidents, internal quarrels and extra costs due to cigarette smoking, protection against environmental tobacco smoke does not entail any higher costs for companies, and economic advantages are visible. The benefits are by far greater than the costs involved, particularly on a long-range basis, and seem to be greater when smoking at the workplace is completely prohibited and no smoking areas are set.

  2. Potential costs of breast augmentation mammaplasty.

    Science.gov (United States)

    Schmitt, William P; Eichhorn, Mitchell G; Ford, Ronald D

    2016-01-01

    Augmentation mammaplasty is one of the most common surgical procedures performed by plastic surgeons. The aim of this study was to estimate the cost of the initial procedure and its subsequent complications, as well as project the cost of Food and Drug Administration (FDA)-recommended surveillance imaging. The potential costs to the individual patient and society were calculated. Local plastic surgeons provided billing data for the initial primary silicone augmentation and reoperative procedures. Complication rates used for the cost analysis were obtained from the Allergen Core study on silicone implants. Imaging surveillance costs were considered in the estimations. The average baseline initial cost of silicone augmentation mammaplasty was calculated at $6335. The average total cost of primary breast augmentation over the first decade for an individual patient, including complications requiring reoperation and other ancillary costs, was calculated at $8226. Each decade thereafter cost an additional $1891. Costs may exceed $15,000 over an averaged lifetime, and the recommended implant surveillance could cost an additional $33,750. The potential cost of a breast augmentation, which includes the costs of complications and imaging, is significantly higher than the initial cost of the procedure. Level III, economic and decision analysis study. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Systematic Review of the Cost and Cost-Effectiveness of Rapid Endovascular Therapy for Acute Ischemic Stroke.

    Science.gov (United States)

    Sevick, Laura K; Ghali, Sarah; Hill, Michael D; Danthurebandara, Vishva; Lorenzetti, Diane L; Noseworthy, Tom; Spackman, Eldon; Clement, Fiona

    2017-09-01

    Rapid endovascular therapy (EVT) is an emerging treatment option for acute ischemic stroke. Several economic evaluations have been published examining the cost-effectiveness of EVT, and many international bodies are currently making adoption decisions. The objective of this study was to establish the cost-effectiveness of EVT for ischemic stroke patients and to synthesize all the publicly available economic literature. A systematic review of the published literature was conducted to identify economic evaluations and cost analyses of EVT for acute ischemic stroke patients. Systematic review best practices were followed, and study quality was assessed. Four-hundred sixty-three articles were identified from electronic databases. After deduplication, abstract review, and full-text review, 17 studies were included. Seven of the studies were cost analyses, and 10 were cost-effectiveness studies. Generally, the cost analyses reported on the cost of the approach/procedure or the hospitalization costs associated with EVT. All of the cost-effectiveness studies reported a cost per quality-adjusted life year as the primary outcomes. Studies varied in regards to the costs considered, the perspective adopted, and the time horizon used. All the studies reported a cost per quality-adjusted life year of cost and cost-effectiveness of EVT. The cost analyses suggested that although EVT was associated with higher costs, it also resulted in improved patient outcomes. From the cost-effectiveness studies, EVT seems to be good value for money when a threshold of $50 000 per quality-adjusted life year gained is adopted. © 2017 American Heart Association, Inc.

  4. Comparison of cost determination of both resource consumption accounting and time-driven activity-based costing systems in a healthcare setting.

    Science.gov (United States)

    Özyapıcı, Hasan; Tanış, Veyis Naci

    2017-05-01

    Objective The aim of the present study was to explore the differences between resource consumption accounting (RCA) and time-driven activity-based costing (TDABC) systems in determining the costs of services of a healthcare setting. Methods A case study was conducted to calculate the unit costs of open and laparoscopic gall bladder surgeries using TDABC and RCA. Results The RCA system assigns a higher cost both to open and laparoscopic gall bladder surgeries than TDABC. The total cost of unused capacity under the TDABC system is also double that in RCA. Conclusion Unlike TDABC, RCA calculates lower costs for unused capacities but higher costs for products or services in a healthcare setting in which fixed costs make up a high proportion of total costs. What is known about the topic? TDABC is a revision of the activity-based costing (ABC) system. RCA is also a new costing system that includes both the theoretical advantages of ABC and the practical advantages of German costing. However, little is known about the differences arising from application of TDABC and RCA. What does this paper add? There is no study comparing both TDABC and RCA in a single case study based on a real-world healthcare setting. Thus, the present study fills this gap in the literature and it is unique in the sense that it is the first case study comparing TDABC and RCA for open and laparoscopic gall bladder surgeries in a healthcare setting. What are the implications for practitioners? This study provides several interesting results for managers and cost accounting researchers. Thus, it will contribute to the spread of RCA studies in healthcare settings. It will also help the implementers of TDABC to revise data concerning the cost of unused capacity. In addition, by separating costs into fixed and variable, the paper will help managers to create a blended (combined) system that can improve both short- and long-term decisions.

  5. Internal Resources to Improve the Quality of Higher Education

    Directory of Open Access Journals (Sweden)

    Tatyana V. Zak

    2016-03-01

    Full Text Available The article deals with the situation in the Russian higher education system. The factors affecting the improvement of the quality of higher education are analyzed. The emphasis is on mass universities. The main obstacles to improving the quality of education in these institutions are the Institute of collective reputation and the high costs of the struggle for improving the quality of education.The necessity of focusing on the actuation of the internal resources to improve the quality associated with the change in the educational process: giving students the right to choose the timing exams and training period at university. The implementation of the proposed measures will reduce the opportunity costs associated with quality improvement activities. The proposed change in the organization of the learning process opens the possibility to estimate the activity of universities in terms of medium-term implementation of educational programs. The use of this indicator will not only combine the two different targets of universities, but also to minimize the costs of opportunistic behavior of teachers and management.

  6. Cost evaluation of clinical laboratory in Taiwan's National Health System by using activity-based costing.

    Science.gov (United States)

    Su, Bin-Guang; Chen, Shao-Fen; Yeh, Shu-Hsing; Shih, Po-Wen; Lin, Ching-Chiang

    2016-11-01

    To cope with the government's policies to reduce medical costs, Taiwan's healthcare service providers are striving to survive by pursuing profit maximization through cost control. This article aimed to present the results of cost evaluation using activity-based costing performed in the laboratory in order to throw light on the differences between costs and the payment system of National Health Insurance (NHI). This study analyzed the data of costs and income of the clinical laboratory. Direct costs belong to their respective sections of the department. The department's shared costs, including public expenses and administrative assigned costs, were allocated to the department's respective sections. A simple regression equation was created to predict profit and loss, and evaluate the department's break-even point, fixed cost, and contribution margin ratio. In clinical chemistry and seroimmunology sections, the cost per test was lower than the NHI payment and their major laboratory tests had revenues with the profitability ratio of 8.7%, while the other sections had a higher cost per test than the NHI payment and their major tests were in deficit. The study found a simple linear regression model as follows: "Balance=-84,995+0.543×income (R2=0.544)". In order to avoid deficit, laboratories are suggested to increase test volumes, enhance laboratory test specialization, and become marginal scale. A hospital could integrate with regional medical institutions through alliances or OEM methods to increase volumes to reach marginal scale and reduce laboratory costs, enhancing the level and quality of laboratory medicine.

  7. Activity-Based Costing in the After Press Services Industry

    Science.gov (United States)

    Shevasuthisilp, Suntichai; Punsathitwong, Kosum

    2009-10-01

    This research was conducted to apply activity-based costing (ABC) in an after press service company in Chiang Mai province, Thailand. The company produces all of its products by one-stop service (such as coating, stitching, binding, die cutting, and gluing). All products are made to order, and have different sizes and patterns. A strategy of low price is used to compete in the marketplace. After cost analysis, the study found that the company has high overhead (36.5% of total cost). The company's problem is its use of traditional cost accounting, which has low accuracy in assigning overhead costs. If management uses this information when pricing customer orders, losses may occur because real production costs may be higher than the selling price. Therefore, the application of ABC in cost analysis can help executives receive accurate cost information; establish a sound pricing strategy; and improve the manufacturing process by determining work activities which have excessively high production costs. According to this research, 6 out of 56 items had a production cost higher than the selling price, leading to losses of 123,923 baht per year. Methods used to solve this problem were: reducing production costs; establishing suitable prices; and creating a sales promotion with lower prices for customers whose orders include processes involving unused capacity. These actions will increase overall sales of the company, and allow more efficient use of its machinery.

  8. The Food Costs of Healthier School Lunches

    OpenAIRE

    Newman, Constance

    2012-01-01

    The U.S. Department of Agriculture proposed and adopted a new set of meal pattern requirements for the National School Lunch Program that will allow schools to claim 6 cents more in lunch reimbursement rates. This study analyzes the food costs of school menus in 2005 that met many of the proposed requirements. Overall, schools that served more, and more diverse, non-starchy vegetables had higher average food costs, and schools that served menus with lower calories had lower food costs. The fo...

  9. THE PRICE OF HIGHER EDUCATION AND INDIVIDUAL DEMAND

    Directory of Open Access Journals (Sweden)

    Filiz Golpek

    2012-01-01

    Full Text Available The rise in the living standards in most of the world, the rise in population and schooling rates have increased the demand for higher education. The attribution of semi public property becomes determinant to decide whom will provide the supply and the production in semi public properties is realized by means of a supply and demand mechanism. The supply of higher education is mostly secured in accordance with the public demand as well as the resources available.  In addition, the fact that higher education services have produced significant benefits has led to over demand. This situation relates to a simple economic rule that a commodity or service which costs almost nothing or little will increase until the mariginal benefit of its demand equals to 0 or almost 0. However, the educational supply and demand is difficult to identify in accordance to the supply and demand and balance of price as observed in the economic theory. The high profits that would be attracted in the future are significant factors influencing individual’s decisions for investment. The decision for investment depends on the possible return in the future, the cost of investment, and the current interest rates. Higher education with investment purposes is influenced by these three factors and higher education is demanded more and more by individuals on the expectation that they will gain high profits In theory, it is accepted that the basic factors identifying the demand for higher education are in harmony with empirical research results in several countries including Turkey.

  10. Cost Per Pound From Orbit

    Science.gov (United States)

    Merriam, M. L.

    2002-01-01

    Traditional studies of Reusable Launch Vehicle (RLV) designs have focused on designs that are completely reusable except for the fuel. This may not be realistic with current technology . An alternate approach is to look at partially reusable launch vehicles. This raises the question of which parts should be reused and which parts should be expendable. One approach is to consider the cost/pound of returning these parts from orbit. With the shuttle, this cost is about three times the cost/pound of launching payload into orbit. A subtle corollary is that RLVs are much less practical for higher orbits, such as the one on which the International Space Station resides, than they are for low earth orbits.

  11. Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

    Directory of Open Access Journals (Sweden)

    Koopmanschap Marc A

    2003-02-01

    Full Text Available Abstract Background Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. This paper discusses patient costs after stroke and compares costs between regular and stroke service care. Methods Costs were calculated within the framework of the evaluation of three experiments with stroke services in the Netherlands. Cost calculations are base on medical consumption data and actual costs. Results 598 patients were consecutively admitted to hospital after stroke. The average total costs of care per patient for the 6 month follow-up are estimated at €16,000. Costs are dominated by institutional and accommodation costs. Patients who die after stroke incur less costs. For patients that survive the acute phase, the most important determinants of costs are disability status and having a partner – as they influence patients' stroke careers. These determinants also interact. The most efficient stroke service experiment was most successful in co-ordinating patient flow from hospital to (nursing home, through capacity planning and efficient discharge procedures. In this region the costs of stroke service care are the same as for regular stroke care. The other experiments suffered from waiting lists for nursing homes and home care, leading to "blocked beds" in hospitals and nursing homes and higher costs of care. Costs of co-ordination are estimated at about 3% of total costs of care. Conclusion This paper demonstrates that by organising care for stroke patients in a stroke service, better health effects can be achieved with the same budget. In addition, it provides insight in need, predisposing and enabling factors that determine costs of care after stroke.

  12. Contemporary Costs Associated With Transcatheter Aortic Valve Replacement: A Propensity-Matched Cost Analysis.

    Science.gov (United States)

    Ailawadi, Gorav; LaPar, Damien J; Speir, Alan M; Ghanta, Ravi K; Yarboro, Leora T; Crosby, Ivan K; Lim, D Scott; Quader, Mohammed A; Rich, Jeffrey B

    2016-01-01

    The Placement of Aortic Transcatheter Valve (PARTNER) trial suggested an economic advantage for transcatheter aortic valve replacement (TAVR) for high-risk patients. The purpose of this study was to evaluate the cost effectiveness of TAVR in the "real world" by comparing TAVR with surgical aortic valve replacement (SAVR) in intermediate-risk and high-risk patients. A multiinstitutional database of The Society of Thoracic Surgeons (STS) (2011 to 2013) linked with estimated cost data was evaluated for isolated TAVR and SAVR operations (n = 5,578). TAVR-treated patients (n = 340) were 1:1 propensity matched with SAVR-treated patients (n = 340). Patients undergoing SAVR were further stratified into intermediate-risk (SAVR-IR: predicted risk of mortality [PROM] 4% to 8%) and high-risk (SAVR-HR: PROM >8%) cohorts. Median STS PROM for TAVR was 6.32% compared with 6.30% for SAVR (SAVR-IR 4.6% and SAVR-HR 12.4%). A transfemoral TAVR approach was most common (61%). Mortality was higher for TAVR (10%) compared with SAVR (6%, p costs compared with SAVR ($69,921 vs $33,598, p cost of TAVR was largely driven by the cost of the valve (all p cost savings versus TAVR. TAVR was associated with greater total costs and mortality compared with SAVR in intermediate-risk and high-risk patients while conferring lower major morbidity and improved resource use. Increased cost of TAVR appears largely related to the cost of the valve. Until the price of TAVR valves decreases, these data suggest that TAVR may not provide the most cost-effective strategy, particularly for intermediate-risk patients. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Executive Compensation and the Cost of Debt

    NARCIS (Netherlands)

    Kabir, Rezaul; Liu, Hao; Veld-Merkoulova, Yulia V.

    2013-01-01

    This study examines how different components of executive compensation affect the cost of debt. We find that debt-like and equity-like pay components have differing effects: an increase in defined benefit pensions is associated with lower bond yield spread, while higher share holdings lead to higher

  14. Activity-Based Costing Model for Assessing Economic Performance.

    Science.gov (United States)

    DeHayes, Daniel W.; Lovrinic, Joseph G.

    1994-01-01

    An economic model for evaluating the cost performance of academic and administrative programs in higher education is described. Examples from its application at Indiana University-Purdue University Indianapolis are used to illustrate how the model has been used to control costs and reengineer processes. (Author/MSE)

  15. Cost Comparison of Fundamentals of Laparoscopic Surgery Training Completed With Standard Fundamentals of Laparoscopic Surgery Equipment versus Low-Cost Equipment.

    Science.gov (United States)

    Franklin, Brenton R; Placek, Sarah B; Wagner, Mercy D; Haviland, Sarah M; O'Donnell, Mary T; Ritter, E Matthew

    Training for the Fundamentals of Laparoscopic Surgery (FLS) skills test can be expensive. Previous work demonstrated that training on an ergonomically different, low-cost platform does not affect FLS skills test outcomes. This study compares the average training cost with standard FLS equipment and medical-grade consumables versus training on a lower cost platform with non-medical-grade consumables. Subjects were prospectively randomized to either the standard FLS training platform (n = 19) with medical-grade consumables (S-FLS), or the low-cost platform (n = 20) with training-grade products (LC-FLS). Both groups trained to proficiency using previously established mastery learning standards on the 5 FLS tasks. The fixed and consumable cost differences were compared. Training occurred in a surgical simulation center. Laparoscopic novice medical student and resident physician health care professionals who had not completed the national FLS proficiency curriculum and who had performed less than 10 laparoscopic cases. The fixed cost of the platform was considerably higher in the S-FLS group (S-FLS, $3360; LC-FLS, $879), and the average consumable training cost was significantly higher for the S-FLS group (S-FLS, $1384.52; LC-FLS, $153.79; p group had a statistically discernable cost reduction for each consumable (Gauze $9.24 vs. $0.39, p = 0.002; EndoLoop $540.00 vs. $40.60, p group versus $1647.95 in the LC-FLS group. This study shows that the average cost to train a single trainee to proficiency using a lower fixed-cost platform and non-medical-grade equipment results in significant financial savings. A 5-resident program will save approximately $8500 annually. Residency programs should consider adopting this strategy to reduce the cost of FLS training. Published by Elsevier Inc.

  16. The variation of acute treatment costs of trauma in high-income countries.

    Science.gov (United States)

    Willenberg, Lynsey; Curtis, Kate; Taylor, Colman; Jan, Stephen; Glass, Parisa; Myburgh, John

    2012-08-21

    In order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries. A systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS), per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities. A total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1%) or charge estimate (25.9%) for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701). However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS), surgical intervention, hospital and intensive care, length of stay, polytrauma and age. The acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied and the cost methods employed are the primary drivers for the

  17. The variation of acute treatment costs of trauma in high-income countries

    Directory of Open Access Journals (Sweden)

    Willenberg Lynsey

    2012-08-01

    Full Text Available Abstract Background In order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries. Methods A systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS, per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities. Results A total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1% or charge estimate (25.9% for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701. However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS, surgical intervention, hospital and intensive care, length of stay, polytrauma and age. Conclusion The acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied

  18. (Super Variable Costing-Throughput Costing)

    OpenAIRE

    Çakıcı, Cemal

    2006-01-01

    (Super Variable Costing-Throughput Costing) The aim of this study is to explain the super-variable costing method which is a new subject in cost and management accounting and to show it’s working practicly.Shortly, super-variable costing can be defined as a costing method which is use only direct material costs in calculate of product costs and treats all costs except these (direct labor and overhead) as periad costs or operating costs.By using super-variable costing method, product costs ar...

  19. Costing the lifecycle of networked learning: documenting the costs from conception to evaluation

    Directory of Open Access Journals (Sweden)

    Paul Bacsich

    2000-12-01

    Full Text Available Analysing the costs of new learning technologies within the educational sector is currently a neglected area, yet the issue of how to spend money effectively in this context is a question that must be answered. This question is made especially pertinent with the current expansion of information technology into higher and further education. To know the costeffectiveness of these initiatives, it is first necessary to gain some comprehension of the costs involved. This must be done in a way that is comprehensible to everyone in academia. A recently completed research study undertaken by the authors addressed these problems.

  20. Costs of health care across primary care models in Ontario.

    Science.gov (United States)

    Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

    2017-08-01

    The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Utilization data for a one year period was measured using administrative databases for a 10% sample selected at random from the Ontario adult population. Primary care and total health care costs were calculated at the individual level and included costs from physician services, hospital visits and admissions, long term care, drugs, home care, lab tests, and visits to non-medical health care providers. Generalized linear model regressions were conducted to assess the differences in costs between primary care models. Patients not enrolled with a primary care physicians were younger, more likely to be males and of lower socio-economic status. Patients in blended capitation models were healthier and wealthier than FFS and enhanced-FFS patients. Primary care and total health care costs were significantly different across Ontario primary care models. Using the traditional FFS as the reference, we found that patients in the enhanced-FFS models had the lowest total health care costs, and also the lowest primary care costs. Patients in the blended capitation models had higher primary care costs but lower total health care costs. Patients that were in multidisciplinary teams (FHT), where physicians are also paid on a blended capitation basis, had higher total health care costs than non-FHT patients but still lower than the FFS reference group. Primary care and total health care costs increased with patients' age, morbidity, and lower income quintile across all primary care payment types. The new primary care models were associated with lower total health care costs for patients compared to the

  1. Resource Requirements and Costs of Developing and Delivering MOOCs

    Directory of Open Access Journals (Sweden)

    Fiona M. Hollands

    2014-11-01

    Full Text Available Given the ongoing alarm regarding uncontrollable costs of higher education, it would be reasonable to expect not only concern about the impact of MOOCs on educational outcomes, but also systematic efforts to document the resources expended on their development and delivery. However, there is little publicly available information on MOOC costs that is based on rigorous analysis. In this article, we first address what institutional resources are required for the development and delivery of MOOCs, based on interviews conducted with 83 administrators, faculty members, researchers, and other actors in the MOOCspace. Subsequently, we use the ingredients method to present cost analyses of MOOC production and delivery at four institutions. We find costs ranging from $38,980 to $325,330 per MOOC, and costs per completer of $74-$272, substantially lower than costs per completer of regular online courses, by merit of scalability. Based on this metric, MOOCs appear more cost-effective than online courses, but we recommend judging MOOCs by impact on learning and caution that they may only be cost-effective for the most self-motivated learners. By demonstrating the methods of cost analysis as applied to MOOCs, we hope that future assessments of the value of MOOCs will combine both cost information and effectiveness data to yield cost-effectiveness ratios that can be compared with the cost-effectiveness of alternative modes of education delivery. Such information will help decision-makers in higher education make rational decisions regarding the most productive use of limited educational resources, to the benefit of both learners and taxpayers.

  2. Does a One-Size-Fits-All Cost-Sharing Approach Incentivize Appropriate Medication Use? A Roundtable on the Fairness and Ethics Associated with Variable Cost Sharing.

    Science.gov (United States)

    Graff, Jennifer S; Shih, Chuck; Barker, Thomas; Dieguez, Gabriela; Larson, Cheryl; Sherman, Helen; Dubois, Robert W

    2017-06-01

    Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration. For example, patients with rheumatoid arthritis may be required to fail low-cost generic treatments before obtaining coverage for a higher-tier tumor necrosis factor alpha inhibitor for which they would have a larger financial burden. Little is known about stakeholders' views on the acceptability of greater patient cost sharing if the individual patient characteristics lead to the higher-cost treatments. To identify and discuss the trade-offs associated with variable cost sharing in pharmacy benefits. To discuss the trade-offs associated with variable cost sharing in pharmacy benefits, we convened an expert roundtable of patient, payer, and employer representatives (panelists). Panelists reviewed background white papers, including an ethics framework; actuarial analysis; legal review; and stakeholder perspectives representing health plan, employer, and patient views. Using case studies, panelists were asked to consider (a) when it would be more (or less) acceptable to require higher cost sharing; (b) the optimal distribution of financial burdens across patients, all plan members, and employers; and (c) the existing barriers and potential solutions to align OOP costs with medically appropriate treatments. Panelists felt it was least acceptable for patients to have greater OOP costs if the

  3. Primary kidney disease and post-renal transplantation hospitalization costs.

    Science.gov (United States)

    Ghoddousi, K; Ramezani, M K; Assari, S; Lankarani, M M; Amini, M; Khedmat, H; Hollisaaz, M T

    2007-05-01

    This study sought to assess posttransplantation hospitalizations costs in diabetic and nondiabetic subjects to see whether diabetes mellitus (DM) as a primary cause of end-stage renal disease (ESRD) increased posttransplantation hospitalization costs. From 2000 to 2005, the hospitalization costs of 387 consecutive rehospitalizations of kidney recipients were retrospectively compared for two groups: patients with ESRD due to DM (n=71) and those with ESRD of non-DM etiologies (n=316). The hospitalization costs included the costs of hotel, medications, surgical procedures, paraclinical tests, imaging tests, health personnel time, special services (ie, patient transportation by ambulance), and miscellaneous costs. Societal perspective was used with costs expressed in PPP$ purchase power parity dollars (PPP$) estimated to be equal to 272 Iranian rials. Compared with the non-DM group, DM patients experienced significantly higher median costs both in total (1262 vs 870 PPP$, P=.001) and in cost components related to hotel (384 vs 215 PPP$, P=.001), health personnel time (235 vs 115 PPP$, P<.001), paraclinical tests (177 vs 149 PPP$, P=.012), and special services (100 vs 74 PPP$, P=.041). The mean of age was higher (P<.001), and the transplantation hospitalization time interval was also shorter in the DM group (median: 2.7 vs 12, P=.025). Considering DM as a leading cause of ESRD and its increasing prevalence in some countries, the association between hospitalization costs of posttransplant patients and DM may be of great economic importance to many transplantation centers.

  4. External costs of nuclear: Greater or less than the alternatives?

    International Nuclear Information System (INIS)

    Rabl, Ari; Rabl, Veronika A.

    2013-01-01

    Since Fukushima many are calling for a shutdown of nuclear power plants. To see whether such a shutdown would reduce the risks for health and environment, the external costs of nuclear electricity are compared with alternatives that could replace it. The frequency of catastrophic nuclear accidents is based on the historical record, about one in 25 years for the plants built to date, an order of magnitude higher than the safety goals of the U.S. Nuclear Regulatory Commission. Impacts similar to Chernobyl and Fukushima are assumed to estimate the cost. A detailed comparison is presented with wind as alternative with the lowest external cost. The variability of wind necessitates augmentation by other sources, primarily fossil fuels, because storage at the required scale is in most regions too expensive. The external costs of natural gas combined cycle are taken as 0.6 €cent/kWh due to health effects of air pollution and 1.25 €cent/kWh due to greenhouse gases (at 25€/t CO 2 eq ) for the central estimate, but a wide range of different parameters is also considered, both for nuclear and for the alternatives. Although the central estimate of external costs of the wind-based alternative is higher than that of nuclear, the uncertainty ranges overlap. - Highlights: ► The external costs of nuclear electricity are compared with the alternatives. ► Frequency and cost of nuclear accidents based on Chernobyl and Fukushima. ► Detailed comparison with wind as alternative with the lowest external costs. ► High external cost of wind because of natural gas backup (storage too limited). ► External costs of wind higher than nuclear but uncertainty ranges overlap

  5. Costs of Robotic-Assisted Versus Traditional Laparoscopy in Endometrial Cancer.

    Science.gov (United States)

    Vuorinen, Riikka-Liisa K; Mäenpää, Minna M; Nieminen, Kari; Tomás, Eija I; Luukkaala, Tiina H; Auvinen, Anssi; Mäenpää, Johanna U

    2017-10-01

    The purpose of this study was to compare the costs of traditional laparoscopy and robotic-assisted laparoscopy in the treatment of endometrial cancer. A total of 101 patients with endometrial cancer were randomized to the study and operated on starting from 2010 until 2013, at the Department of Obstetrics and Gynecology of Tampere University Hospital, Tampere, Finland. Costs were calculated based on internal accounting, hospital database, and purchase prices and were compared using intention-to-treat analysis. Main outcome measures were item costs and total costs related to the operation, including a 6-month postoperative follow-up. The total costs including late complications were 2160 &OV0556; higher in the robotic group (median for traditional 5823 &OV0556;, vs robot median 7983 &OV0556;, P costs for instruments and equipment as well as to more expensive operating room and postanesthesia care unit time. Traditional laparoscopy involved higher costs for operation personnel, general costs, medication used in the operation, and surgeon, although these costs were not substantial. There was no significant difference in in-patient stay, laboratory, radiology, blood products, or costs related to complications. According to this study, robotic-assisted laparoscopy is 37% more expensive than traditional laparoscopy in the treatment of endometrial cancer. The cost difference is mainly explained by amortization of the robot and its instrumentation.

  6. When Industries Change: The Future of Higher Education.

    Science.gov (United States)

    Collis, David

    2001-01-01

    Factors altering the higher education industry include radical change in the type of students, necessity of lifetime education, and new technologies. These factors are increasing the entry of private-sector players. Strategic university responses may be strengthening of accreditation, cost-cutting and efficiency measures, horizontal…

  7. Improving Measurement of Productivity in Higher Education

    Science.gov (United States)

    Massy, William F.; Sullivan, Teresa A.; Mackie, Christopher

    2013-01-01

    Higher education is a critical element of the American economy, because of both its benefits and its costs to individuals and taxpayers. Yet we know very little about the relationships between the things colleges and universities do and the resources they need to do them. Currently, shrinking public support and increasing tuition make it urgent…

  8. Transaction-cost Expenditures and the Relative Performance of Mutual Funds

    OpenAIRE

    John M.R. Chalmers; Roger M. Edelen; Gregory B. Kadlec

    1999-01-01

    We directly estimate annual trading costs for a sample of equity mutual funds and find that these costs are large and exhibit substantial cross sectional variation. Trading costs average 0.78% of fund assets per year and have an inter-quartile range of 0.59%. Trading costs, like expense ratios, are negatively related to fund returns and we find no evidence that on average trading costs are recovered in higher gross fund returns. We find that our direct estimates of trading costs have more exp...

  9. Labour cost of radiation dose

    International Nuclear Information System (INIS)

    Cook, A.; Lockett, L.E.

    1978-01-01

    In order to optimise capital expenditure on measures to protect workers against radiation it would be useful to have a means to measure radiation dose in money terms. Because labour has to be employed to perform radiation work there must be some relationship between the wages paid and the doses received. Where the next increment of radiation dose requires additional labour to be recruited the cost will at least equal the cost of the extra labour employed. This paper examines some of the factors which affect the variability of the labour cost of radiation dose and notes that for 'in-plant' exposures the current cost per rem appears to be significantly higher than values quoted in ICRP Publication 22. An example is given showing how this concept may be used to determine the capital it is worth spending on installed plant to prevent regular increments of radiation dose to workers. (author)

  10. A Low Cost Ferritic Stainless Steel Microalloyed by Higher Nb for Automotive Exhaust System

    Science.gov (United States)

    Chen, Erhu; Wang, Xuelin; Shang, Chengjia

    Automotive engine exhaust gas after combustion of fuel, and the gas will be liquefied in the rear of automotive exhaust system. A lot of corrosive anions existing in the condensate make corrosion of the exhaust system materials. Therefore, once pitting perforation, automotive exhaust system will fail directly. In 1980s, automotive exhaust manifold was made of Si-Mo ductile iron, mufflers and the tail pipe were made of carbon steel or aluminized steel. But with higher emission standards carried out, the improvement of engine performance and the higher exhaust temperature as well as the needs of the automotive light-weighting, we need the higher corrosion resistance of the material for automotive exhaust systems to meet the requirements.

  11. Cost Recovery Through Depreciation.

    Science.gov (United States)

    Forrester, Robert T.; Wesolowski, Leonard V.

    1983-01-01

    The approach of adopting depreciation rather than use allowance in order to recover more accurately the cost of college buildings and equipment used on federal projects is considered. It is suggested that depreciation will offer most colleges and universities a higher annual recovery rate, and an opportunity for better facilities planning. For…

  12. Value Added: The Costs and Benefits of College Preparatory Programs. American Higher Education Report Series

    Science.gov (United States)

    Swail, Watson Scott

    2004-01-01

    Rarely do stakeholders ask about the effectiveness of outreach programs or whether they are an efficient use of tax dollars and philanthropic funds. As government budgets continue to be constrained and philanthropic investment gets more competitive, there is a growing acknowledgment of the need to look at the cost/benefit of these programs and…

  13. Understanding Health Care Costs in a Wisconsin Acute Leukemia Population

    Directory of Open Access Journals (Sweden)

    Patricia Steinert

    2016-08-01

    Full Text Available Purpose: We investigated factors driving health care costs of patients with a diagnosis of acute myeloid and acute lymphoblastic leukemia. Methods: Standard costs identified in insurance claims data obtained from the Wisconsin Health Information Organization were used in a sample of 837 acute leukemia patients from April 2009 to June 2011. The Andersen behavioral model of health care utilization guided selection of patient and community factors expected to influence health care costs. A generalized linear model fitting gamma-distributed data with log-link technique was used to analyze cost. Results: Type of treatment received and disease severity represented significant cost drivers, and patients receiving at least some of their treatment from academic medical centers experienced higher costs. Inpatient care and pharmacy costs of patients who received treatment from providers located in areas of higher poverty experienced lower costs, raising questions of potential treatment and medical practice disparities between provider locations. Directions of study findings were not consistent between different types of services received and underscore the complexity of investigating health care cost. Conclusions: While prevalence of acute leukemia in the United States is low compared to other diseases, its extreme high cost of treatment is not well understood and potentially influences treatment decisions. Acute leukemia health care costs may not follow expected patterns; further exploration of the relationship between cost and the treatment decision, and potential treatment disparities between providers in different socioeconomic locations, is needed.

  14. A predation cost to bold fish in the wild

    DEFF Research Database (Denmark)

    Hulthén, Kaj; Chapman, Ben; Nilsson, Anders P.

    2017-01-01

    in the animal kingdom. Theory predicts that individual behavioural types differ in a cost-benefit trade-off where bolder individuals benefit from greater access to resources while paying higher predation-risk costs. However, explicitly linking predation events to individual behaviour under natural conditions...

  15. Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

    Directory of Open Access Journals (Sweden)

    Hong J. Kan

    2013-01-01

    Full Text Available Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE in a US Medicaid population were examined. Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE. Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001. Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754. Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

  16. Strategic Thinking about How Costs and Goals Interact

    Science.gov (United States)

    Cavanaugh, John C.; Graves, William H.

    2010-01-01

    In the grand economic scheme, the intense public pressure to lower costs came late to higher education. No institution--public or private, non-profit or for-profit--has escaped the always difficult, sometimes protracted discussions of how to increase efficiency and lower costs. Although this intense pressure predates the recent great recession,…

  17. Modeling diffuse phosphorus emissions to assist in best management practice designing

    Science.gov (United States)

    Kovacs, Adam; Zessner, Matthias; Honti, Mark; Clement, Adrienne

    2010-05-01

    -bounded P load values at any arbitrary point within the catchment. Finally, a simple design procedure has been built up to plan BMPs in the catchments and simulate their possible impacts on diffuse P fluxes as well as calculate their approximately costs. Both source and transport controlling measures have been involved into the planning procedure. The model also allows examining the impacts of alterations of fertilizer application, point source emissions as well as the climate change on the river loads. Besides this, a simple optimization algorithm has been developed to select the most effective source areas (real hot spots), which should be targeted by the interventions. The fate model performed well in Hungarian pilot catchments. Using the calibrated and validated model, different management scenarios were worked out and their effects and costs evaluated and compared to each other. The results show that the approach is suitable to effectively design BMP measures at local scale. Combinative application of the source and transport controlling BMPs can result in high P reduction efficiency. Optimization of the interventions can remarkably reduce the area demand of the necessary BMPs, consequently the establishment costs can be decreased. The model can be coupled with a larger scale catchment model to form a "screening and planning" modeling system.

  18. The hidden costs of nuclear energy

    International Nuclear Information System (INIS)

    Sweet, C.

    1978-01-01

    A lynch pin of the pro-nuclear argument is that atomic energy provides cheap electricity. Many are sceptical of such claims, realising that a lot of figures have been omitted from the accounting - the cost of R and D, of dismantling the obsolete stations and of waste management - but having no access to all the figures, such scepticism has remained little more than a hunch. Using conventional economic accounting it is shown that nuclear power must be considerably more costly than has ever been admitted by any of the authorities. The CEGB claims that reprocessing amounts to no more than 8 per cent of the total costs of nuclear generated electricity. According to the present author the costs are 20 per cent - and that 20 per cent is of a much higher figure. (author)

  19. Cost analysis of singleton versus twin pregnancies after in vitro fertilization.

    Science.gov (United States)

    Lukassen, H G Marieke; Schönbeck, Yvonne; Adang, Eddy M M; Braat, Didi D M; Zielhuis, Gerhard A; Kremer, Jan A M

    2004-05-01

    To determine the difference in costs between singleton and twin pregnancies after IVF treatment from pregnancy to 6 weeks after delivery from a health care perspective. Retrospective cost analysis. IVF department at the University Medical Center Nijmegen, The Netherlands. A representative sample of singleton and twin pregnancies after IVF treatment between 1995 and 2001 at the University Medical Center Nijmegen. IVF with or without intracytoplasmic sperm injection and with or without cryopreservation. Medical costs per singleton and twin pregnancy after IVF. In patients pregnant with twins, the incidence of hospital antenatal care, complicated vaginal deliveries, and cesarean sections was higher and was associated with more frequent and longer maternal and neonatal hospital admissions. Maternal and neonatal hospital admissions were the major cost drivers. The medical cost per twin pregnancy was found to be more than five times higher than per singleton pregnancy, 13,469 and 2,550, respectively. The medical cost per twin pregnancy was more than 10,000 higher than per singleton pregnancy. A reduction in the number of twin pregnancies by elective single ET will save substantial amounts of money. This money might be used for the additional IVF cycles that will probably be needed to achieve similar success rates between single ET and two-embryo transfer.

  20. Enhanced osteogenesis of adipose derived stem cells with Noggin suppression and delivery of BMP-2.

    Directory of Open Access Journals (Sweden)

    Jiabing Fan

    Full Text Available Bone morphogenetic proteins (BMPs are believed to be the most potent osteoinductive factors. However, BMPs are highly pleiotropic molecules and their supra-physiological high dose requirement leads to adverse side effects and inefficient bone formation. Thus, there is a need to develop alternative osteoinductive growth factor strategies that can effectively complement BMP activity. In this study, we intrinsically stimulated BMP signaling in adipose derived stem cells (ASCs by downregulating noggin, a potent BMP antagonist, using an RNAi strategy. ASCs transduced with noggin shRNA significantly enhanced osteogenic differentiation of cells. The potency of endogenous BMPs was subsequently enhanced by stimulating ASCs with exogenous BMPs at a significantly reduced dose. The level of mineralization in noggin shRNA treated ASCs when treated with BMP-2 was comparable to that of control shRNA treated cell treated with 10-fold more BMP-2. The complementary strategy of noggin suppression + BMP-2 to enhance osteogenesis was further confirmed in 3D in vitro environments using scaffolds consisting of chitosan (CH, chondroitin sulfate (CS, and apatite layer on their surfaces designed to slowly release BMP-2. This finding supports the novel therapeutic potential of this complementary strategy in bone regeneration.

  1. Real money: complications and hospital costs in trauma patients.

    Science.gov (United States)

    Hemmila, Mark R; Jakubus, Jill L; Maggio, Paul M; Wahl, Wendy L; Dimick, Justin B; Campbell, Darrell A; Taheri, Paul A

    2008-08-01

    Major postoperative complications are associated with a substantial increase in hospital costs. Trauma patients are known to have a higher rate of complications than the general surgery population. We used the National Surgical Quality Improvement Program (NSQIP) methodology to evaluate hospital costs, duration of stay, and payment associated with complications in trauma patients. Using NSQIP principles, patient data were collected for 512 adult patients admitted to the trauma service for > 24 hours at a Level 1 trauma center (2004-2005). Patients were placed in 1 of 3 groups: no complications (none), >or=1 minor complication (minor, eg, urinary tract infection), or >or=1 major complication (major, eg, pneumonia). Total hospital charges, costs, payment, and duration of stay associated with each complication group were determined from a cost-accounting database. Multiple regression was used to determine the costs of each type of complication after adjusting for differences in age, sex, new injury severity score, Glasgow coma scale score, maximum head abbreviated injury scale, and first emergency department systolic blood pressure. A total of 330 (64%) patients had no complications, 53 (10%) had >or= 1 minor complication, and 129 (25%) had >or= 1 major complication. Median hospital charges increased from $33,833 (none) to $81,936 (minor) and $150,885 (major). The mean contribution to margin per day was similar for the no complication and minor complication groups ($994 vs $1,115, P = .7). Despite higher costs, the patients in the major complication group generated a higher mean contribution to margin per day compared to the no complication group ($2,168, P costs when adjusted for confounding variables was $19,915 for the minor complication group (P costs associated with traumatic injury provides a window for assessing the potential cost reductions associated with improved quality care. To optimize system benefits, payers and providers should develop integrated

  2. What Are the Alternatives to Student Loans in Higher Education Funding?

    Science.gov (United States)

    Stokes, Anthony; Wright, Sarah

    2010-01-01

    In a period of student loan scandals and U.S. financial market instability impacting on the cost and availability of student loans, this paper looks at alternative models of higher education funding. In this context, it also considers the level of financial support that the government should provide to higher education.

  3. Long-term impact of war on healthcare costs: an eight-country study.

    Directory of Open Access Journals (Sweden)

    Ramon Sabes-Figuera

    Full Text Available Exposure to war can negatively affect health and may impact on healthcare costs. Estimating these costs and identifying their predictors is important for appropriate service planning. We aimed to measure use of health services in an adult population who had experienced war in the former-Yugoslavia on average 8 years previously, and to identify characteristics associated with the use and costs of healthcare.War-affected community samples in Bosnia-Herzegovina, Croatia, Kosovo, FYR Macedonia, and Serbia were recruited through a random walk technique. Refugees in Germany, Italy and the UK were contacted through registers, organisations and networking. Current service use was measured for the previous three months and combined with unit costs for each country for the year 2006/7. A two-part approach was used, to identify predictors of service use with a multiple logistic regression model and predictors of cost with a generalised linear regression model.3,313 participants were interviewed in Balkan countries and 854 refugees in Western European countries. In the Balkan countries, traumatic events and mental health status were related to greater service use while in Western countries these associations were not found. Participants in Balkan countries with post traumatic stress disorder (PTSD had costs that were 63% higher (p = 0.005 than those without PTSD. Distress experienced during the most traumatic war event was associated with higher costs (p = 0.013. In Western European countries costs were 76% higher if non-PTSD anxiety disorders were present (0.027 and 63% higher for mood disorders (p = 0.006.War experiences and their effects on mental health are associated with increased health care costs even many years later, especially for those who stayed in the area of conflict. Focussing on the mental health impact of war is important for many reasons including those of an economic nature.

  4. Regional differences in China's CO2 abatement cost

    International Nuclear Information System (INIS)

    He, Xiaoping

    2015-01-01

    Under a framework of output distance function with multiple outputs, the study discusses the carbon abatement cost at provincial and regional levels in China, using the shadow price analysis. The findings show that the abatement cost, reflecting the marginal opportunity cost of carbon reduction, varies greatly among the provinces. On average, the abatement cost of the eastern region was much higher than that of the mid-western region during the observed period. The findings provide evidence that the carbon prices in the current ETS pilots have been much lower than desired levels, implying inefficiency of the markets. The wide range of the abatement cost estimates supports that the equi-marginal principle does not hold for the regulations on carbon pollution at regional levels. The regional cost differences indicate the huge potential for China to minimize the total abatement cost with policy instruments that may motive the emissions moving from areas of low abatement cost to where the abatement cost is higher. For a few undeveloped provinces that are environmentally fragile and have high abatement cost, supplementary measures will be needed to reduce the negative impact of carbon cutbacks on the poor to the minimum. - Highlights: • The marginal abatement cost of CO 2 is defined by the shadow price measure. • A linear programming model based on distance function is established. • Marginal abatement costs at provincial level are empirical investigated. • The abatement cost varies across provinces and regions in China. • The findings provide evidence that the current ETS pilots are inefficient

  5. Exploring Business Models for MOOCS in Higher Education

    Science.gov (United States)

    Burd, Elizabeth L.; Smith, Shamus P.; Reisman, Sorel

    2015-01-01

    Massive Open Online Courses (MOOCs) potentially challenge the traditional dominance of brick and mortar institutions as providers of quality higher education. The benefits for students include reduced education costs and global access to exclusive institution courses and instructors. However, the benefits for institutions are less clear as there…

  6. Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs.

    Science.gov (United States)

    Brady, Brenna L; Tkacz, Joseph; Meyer, Roxanne; Bolge, Susan C; Ruetsch, Charles

    2017-02-01

    The objective was to examine the relationship between health care costs and quality in rheumatoid arthritis (RA). Administrative claims were used to calculate 8 process measures for the treatment of RA. Associated health care costs were calculated for members who achieved or did not achieve each of the measures. Medical, pharmacy, and laboratory claims for RA patients (International Classification of Diseases, Ninth Revision, Clinical Modification 714.x) were extracted from the Optum Clinformatics Datamart database for 2011. Individuals were predominately female and in their mid-fifties. Measure achievement ranged from 55.9% to 80.8%. The mean cost of care for members meeting the measure was $18,644; members who did not meet the measures had a mean cost of $14,973. Primary cost drivers were pharmacy and office expenses, accounting for 42.4% and 26.3% of total costs, respectively. Regression analyses revealed statistically significant associations between biologic usage, which was more prevalent in groups attaining measures, and total expenditure across all measures (Ps < 0.001). Pharmacy costs were similar between both groups. Individuals meeting the measures had a higher proportion of costs accounted for by office visits; those not meeting the measures had a higher proportion of costs from inpatient and outpatient visits. These findings suggest that increased quality may lead to lower inpatient and outpatient hospital costs. Yet, the overall cost of RA care is likely to remain high because of intensive pharmacotherapy regimens.

  7. Application of a New Integrated Decision Support Tool (i-DST) for Urban Water Infrastructure: Analyzing Water Quality Compliance Pathways for Three Los Angeles Watersheds

    Science.gov (United States)

    Gallo, E. M.; Hogue, T. S.; Bell, C. D.; Spahr, K.; McCray, J. E.

    2017-12-01

    The water quality of receiving streams and waterbodies in urban watersheds are increasingly polluted from stormwater runoff. The implementation of Green Infrastructure (GI), which includes Low Impact Developments (LIDs) and Best Management Practices (BMPs), within a watershed aim to mitigate the effects of urbanization by reducing pollutant loads, runoff volume, and storm peak flow. Stormwater modeling is generally used to assess the impact of GIs implemented within a watershed. These modeling tools are useful for determining the optimal suite of GIs to maximize pollutant load reduction and minimize cost. However, stormwater management for most resource managers and communities also includes the implementation of grey and hybrid stormwater infrastructure. An integrated decision support tool, called i-DST, that allows for the optimization and comprehensive life-cycle cost assessment of grey, green, and hybrid stormwater infrastructure, is currently being developed. The i-DST tool will evaluate optimal stormwater runoff management by taking into account the diverse economic, environmental, and societal needs associated with watersheds across the United States. Three watersheds from southern California will act as a test site and assist in the development and initial application of the i-DST tool. The Ballona Creek, Dominguez Channel, and Los Angeles River Watersheds are located in highly urbanized Los Angeles County. The water quality of the river channels flowing through each are impaired by heavy metals, including copper, lead, and zinc. However, despite being adjacent to one another within the same county, modeling results, using EPA System for Urban Stormwater Treatment and Analysis INtegration (SUSTAIN), found that the optimal path to compliance in each watershed differs significantly. The differences include varied costs, suites of BMPs, and ancillary benefits. This research analyzes how the economic, physical, and hydrological differences between the three

  8. Uncertainty in relative cost investigation

    International Nuclear Information System (INIS)

    Bunn, D.; Viahos, K.

    1989-01-01

    One of the consequences of the privatization of the Central Electricity Generating Board has been a weakening of the economic case for nuclear generation over coal. Nuclear has higher capital, but lower operating costs than coal and is therefore favoured in capital budgeting by discounting at lower rates of return. In the Sizewell case (in 1987), discounting at the public sector rate of 5 per cent favoured nuclear. However, the private sector will require higher rates of return, thus rendering nuclear less attractive. Hence the imposition by the government of a diversity constraint on the privatized industry to ensure that contracts are made for a minimum fraction of non-fossil (essentially nuclear) energy. An electricity capacity planning model was developed to estimate the costs of imposing various non-fossil energy constraints on the planning decision of a privatized electricity supply industry, as a function of various discount rates. Using a large-scale linear programming technique, the model optimizes over a 50 year horizon the schedule of installation, and mix of generating capacity, both with and without a minimum non-fossil constraint. The conclusion is that the opportunity cost of diversity may be a complex joint substation of more than one type of plant (eg coal and gas) depending on the discount rate. (author)

  9. The effectiveness and resilience of phosphorus management practices in the Lake Simcoe watershed, Ontario, Canada

    Science.gov (United States)

    Crossman, J.; Futter, M. N.; Palmer, M.; Whitehead, P. G.; Baulch, H. M.; Woods, D.; Jin, L.; Oni, S. K.; Dillon, P. J.

    2016-09-01

    Uncertainty surrounding future climate makes it difficult to have confidence that current nutrient management strategies will remain effective. This study used monitoring and modeling to assess current effectiveness (% phosphorus reduction) and resilience (defined as continued effectiveness under a changing climate) of best management practices (BMPs) within five catchments of the Lake Simcoe watershed, Ontario. The Integrated Catchment Phosphorus model (INCA-P) was used, and monitoring data were used to calibrate and validate a series of management scenarios. To assess current BMP effectiveness, models were run over a baseline period 1985-2014 with and without management scenarios. Climate simulations were run (2070-2099), and BMP resilience was calculated as the percent change in effectiveness between the baseline and future period. Results demonstrated that livestock removal from water courses was the most effective BMP, while manure storage adjustments were the least. Effectiveness varied between catchments, influenced by the dominant hydrological and nutrient transport pathways. Resilience of individual BMPs was associated with catchment sensitivity to climate change. BMPs were most resilient in catchments with high soil water storage capacity and small projected changes in frozen-water availability and in soil moisture deficits. Conversely, BMPs were less resilient in catchments with larger changes in spring melt magnitude and in overland flow proportions. Results indicated that BMPs implemented are not always those most suited to catchment flow pathways, and a more site-specific approach would enhance prospects for maintaining P reduction targets. Furthermore, BMP resilience to climate change can be predicted from catchment physical properties and present-day hydrochemical sensitivity to climate forcing.

  10. Sustaining Higher Education Using Wal-Mart's Best Supply Chain Management Practices

    Science.gov (United States)

    Comm, Clare L.; Mathaisel, Dennis F. X.

    2008-01-01

    Purpose: The costs in higher education are increasing and need to be controlled. This paper aims to demonstrate what lessons higher education could learn from Wal-Mart's reasons for its financial success with its focus on efficient and effective supply chain management (SCM) best practices. Design/methodology/approach: Wal-Mart's best practices in…

  11. Controlling costs without compromising quality: paying hospitals for total knee replacement.

    Science.gov (United States)

    Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J

    2010-10-01

    Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P costs ($12,773-$11,512; P costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.

  12. ON A COURNOT DUOPOLY GAME WITH DIFFERENTIATED GOODS, HETEROGENEOUS EXPECTATIONS AND A COST FUNCTION INCLUDING EMISSION COSTS

    Directory of Open Access Journals (Sweden)

    Georges SARAFOPOULOS

    2017-07-01

    Full Text Available In this study we investigate the dynamics of a nonlinear Cournot- type duopoly game with differentiated goods, linear demand and a cost function that includes emission costs. The game is modeled with a system of two difference equations. Existence and stability of equilibria of this system are studied. We show that the model gives more complex chaotic and unpredictable trajectories as a consequence of change in the parameter of horizontal product differentiation and a higher (lower degree of product differentiation (weaker or fiercer competition destabilize (stabilize the economy. The chaotic features are justified numerically via computing Lyapunov numbers and sensitive dependence on initial conditions. Also, we show that in this case there are stable trajectories and a higher (lower degree of product differentiation does not tend to destabilize the economy.

  13. Making College Worth It: A Review of the Returns to Higher Education

    Science.gov (United States)

    Oreopoulos, Philip; Petronijevic, Uros

    2013-01-01

    Despite a general rise in the return to college, likely due to technological change, the cost-benefit calculus facing prospective students can make the decision to invest in and attend college dauntingly complex. Philip Oreopoulos and Uros Petronijevic review research on the varying costs and benefits of higher education and explore in full the…

  14. Estimating the cost-effectiveness of linezolid for the treatment of methicillin-resistant Staphylococcus aureus nosocomial pneumonia in Taiwan.

    Science.gov (United States)

    Lin, Po-Chang; Wang, Bruce C M; Kim, Richard; Magyar, Andrew; Lai, Chung-Chih; Yang, Ya-Wen; Huang, Yhu-Chering

    2016-02-01

    Methicillin-resistant Staphylococcus aureus (MRSA) nosocomial pneumonia (NP) is associated with higher resource utilization, increased hospital stays, and mortality. We present a health economics model to understand the impact of using linezolid as the first-line treatment of MRSA NP in Taiwan. We developed a cost-effectiveness model to estimate the costs and clinical outcomes of using linezolid 600 mg b.i.d. versus vancomycin 15 mg/kg b.i.d. as the first-line treatment of MRSA NP in Taiwan. The model is a decision-analytic analysis in which a MRSA-confirmed patient is simulated to utilize one of the treatments, using data from a clinical trial. Within each treatment arm, the patient can or cannot achieve clinical cure. Regardless of whether the clinical cure was achieved or not, the patient may or may not have experienced an adverse event. The per-protocol results for clinical cure were 57.6% and 46.6% for linezolid and vancomycin, respectively. The total cost of linezolid was $376 more per patient than that of vancomycin. Drug costs were higher for linezolid than for vancomycin ($1108 vs. $233), and hospitalization costs were lower ($4998 vs. $5496). With higher cost and higher cure rates for linezolid, the incremental cost per cure was $3421. This study projects linezolid to have higher drug costs, lower hospital costs, and higher overall costs compared with vancomycin. This is balanced against the higher clinical cure rate for linezolid. Depending on the willingness to pay for clinical cure, linezolid could be cost effective as the first-line treatment of NP in Taiwan. Copyright © 2015. Published by Elsevier B.V.

  15. Cost-benefit of ventilation and averted radon in dwellings

    International Nuclear Information System (INIS)

    Katona, T.; Kanyar, B.

    2003-01-01

    To assess an economically optimal ventilation rate we have introduced a cost-benefit analysis taking into account the cost of heating and benefit of averted dose due to ventilation. The cost of heating due to the elevated ventilation for mitigation of radon content in dwellings can be compensated by the monetary benefit of the averted dose, in case of higher (annually 3-10 mSv) exposure. During the heating season the economically optimal ventilation takes 0.1-0.5 h -1 , meanwhile the radon concentration in the indoor air decreases to 200-800 Bq/m 3 , depending on the exhalation of radon, number of persons living in the dwellings and other local parameters. Our results from the optimal planning correspond to the radon concentrations recommended by the international organizations as action levels. In general, the periodic ventilation in daytime provides a higher averted dose than the constant one in case of the same heating cost. (authors)

  16. Cost and affordability of healthy food in rural South Australia.

    Science.gov (United States)

    Ward, P R; Coveney, J; Verity, F; Carter, P; Schilling, M

    2012-01-01

    As in many other countries, Australian consumers have recently had to accommodate increases in costs of basic food, and during the financial year 2007-2008 overall food prices rose by nearly 4%. Food costs are mediating factors in food choice, especially for low-income groups, where food security is often tenuous. There are reports that rural populations may have higher levels of food insecurity, although the evidence is often contradictory. To assess cost and affordability of food in rural areas this study used the Healthy Food Basket (HFB) methodology, which has been applied in a number of settings. The HFBs were costed at supermarkets and stores in different locations with different degrees of rurality. Compared with metropolitan areas, healthy food is more expensive in rural areas; costs are even higher in more remote areas. The overall affordability of HFB in rural areas was not significantly different from metro areas. The main difference concerned low socio-economic status (SES) groups, where the proportion of household income spent on the HFB was three times that of higher SES groups. The unaffordability of healthy food, or 'food stress' in low SES groups is a concern, especially when this group carries the greatest burden of diet-related disease. Findings suggest that there is a need to consider both rurality and SES when developing policy responses to decrease the cost and increase the affordability of healthy foods in rural and remote areas.

  17. The indirect costs of multiple sclerosis: systematic review and meta-analysis.

    Science.gov (United States)

    Stawowczyk, Ewa; Malinowski, Krzysztof Piotr; Kawalec, Paweł; Moćko, Paweł

    2015-01-01

    The aim of this systematic review is to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with multiple sclerosis. Searches were conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2014 prices US$ using the consumer price index and purchasing power parity (scenario 1) and expressed as proportion of specific gross domestic product in current local currency unit to adjust for country's development (scenario 2). Identified studies were then analyzed in order to assess their possible inclusion in the meta-analysis. The authors identified 63 records, of which 23 were eligible for meta-analysis. Overall indirect cost per patient calculated in scenario 1 was as high as US$20,167 with US$22,197 in Europe, US$17,382 in North America and US$153 in Asia. Overall indirect cost per patient calculated in scenario 2 was equal to US$16,939, with US$19,612 in Europe, US$11,592 in North America and US$899 in Asia. Overall indirect costs varied from US$3726 for patients with EDSS score less than 3 to US$19,264 for patients with Expanded Disability Status Scale score grater that 7. This review revealed the great economic burden of multiple sclerosis on society. The authors observed a great variety of the considered components of indirect costs and their definitions. Costs were higher for Europe than for other continents and were also higher for patients with a higher Expanded Disability Status Scale score.

  18. EMBL pay settlement will cost millions

    CERN Multimedia

    Abott, A

    1999-01-01

    A labour dispute at EMBL, Heidelberg, was settled last week at a cost of at least DM4 million for the organisation's 16 member states. The lab has asked for clarification on whether the ruling from the IL0 refers simply to a salary adjustment from 1995 or also to a backdated implementation of higher salary scales. This second option would cost considerably more - 8 percent of the budget in back pay and DM3.5 million per annum (1/2 page).

  19. Cath lab costs in patients undergoing percutaneous coronary angioplasty - detailed analysis of consecutive procedures.

    Science.gov (United States)

    Dziki, Beata; Miechowicz, Izabela; Iwachów, Piotr; Kuzemczak, Michał; Kałmucki, Piotr; Szyszka, Andrzej; Baszko, Artur; Siminiak, Tomasz

    2017-01-01

    Costs of percutaneous coronary interventions (PCI) have an important impact on health care expenditures. Despite the present stress upon the cost-effectiveness issues in medicine, few comprehensive data exist on costs and resource use in different clinical settings. To assess catheterisation laboratory costs related to use of drugs and single-use devices in patients undergoing PCI due to coronary artery disease. Retrospective analysis of 1500 consecutive PCIs (radial approach, n = 1103; femoral approach, n = 397) performed due to ST segment elevation myocardial infarction (STEMI; n = 345) and non ST-segment elevation myocardial infarction (NSTEMI; n = 426) as well as unstable angina (UA; n = 489) and stable angina (SA; n = 241) was undertaken. Comparative cost analysis was performed and shown in local currency units (PLN). The cath lab costs were higher in STEMI (4295.01 ± 2384.54PLN, p costs were positively correlated with X-ray dose, fluoroscopy, and total procedure times. Patients' age negatively correlated with cath lab costs in STEMI/NSTEMI patients. Cath lab costs were higher in STEMI patients compared to other groups. In STEMI/NSTEMI they were lower in older patients. In all analysed groups costs were related to the level of procedural difficulty. In female patients, the costs of PCI performed via radial approach were higher compared to femoral approach. Despite younger age, male patients underwent more expensive procedures.

  20. Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

    Science.gov (United States)

    Chin, Garwin; Wright, David J.; Snir, Nimrod; Schwarzkopf, Ran

    2018-01-01

    Introduction Increasing hip fracture incidence in the United States is leading to higher occurrences of conversion total hip arthroplasty (THA) for failed surgical treatment of the hip. In spite of studies showing higher complication rates in conversion THA, the Centers for Medicare and Medicaid services currently bundles conversion and primary THA under the same diagnosis-related group. We examined the cost of treatment of conversion THA compared with primary THA. Our hypothesis is that conversion THA will have higher cost and resource use than primary THA. Methods Fifty-one consecutive conversion THA patients (Current Procedure Terminology code 27132) and 105 matched primary THA patients (Current Procedure Terminology code 27130) were included in this study. The natural log-transformed costs for conversion and primary THA were compared using regression analysis. Age, gender, body mass index, American Society of Anesthesiologist, Charlson comorbidity score, and smoker status were controlled in the analysis. Conversion THA subgroups formed based on etiology were compared using analysis of variance analysis. Results Conversion and primary THAs were determined to be significantly different (P conversion THA has significantly greater cost and resource use than primary THA. In order to prevent disincentives for treating these complex surgical patients, reclassification of conversion THA is needed, as they do not fit together with primary THA. PMID:26387923

  1. The cost of dysphagia in geriatric patients

    Directory of Open Access Journals (Sweden)

    Westmark S

    2018-06-01

    Full Text Available Signe Westmark,1 Dorte Melgaard,1,2 Line O Rethmeier,3 Lars Holger Ehlers3 1Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark; 2Department of Physiotherapy and Occupational Therapy, North Denmark Regional Hospital, Hjørring, Denmark; 3Danish Center for Healthcare Improvements, Aalborg University, Aalborg, Denmark Objectives: To estimate the annual cost at the hospital and in the municipality (social care due to dysphagia in geriatric patients.Design: Retrospective cost analysis of geriatric patients with dysphagia versus geriatric patients without dysphagia 1 year before hospitalization.Setting: North Denmark Regional Hospital, Hjørring Municipality, Frederikshavn Municipality, and Brønderslev Municipality.Subjects: A total of 258 hospitalized patients, 60 years or older, acute hospitalized in the geriatric department.Materials and methods: Volume-viscosity swallow test and the Minimal Eating Observation Form-II were conducted for data collection. A Charlson Comorbidity Index score measured comorbidity, and functional status was measured by Barthel-100. To investigate the cost of dysphagia, patient-specific data on health care consumption at the hospital and in the municipality (nursing, home care, and training were collected from medical registers and records 1 year before hospitalization including the hospitalization for screening for dysphagia. Multiple linear regression analyses were conducted to determine the relationship between dysphagia and hospital and municipality costs, respectively, adjusting for age, gender, and comorbidity.Results: Patients with dysphagia were significantly costlier than patients without dysphagia in both hospital (p=0.013 and municipality costs (p=0.028 compared to patients without dysphagia. Adjusted annual hospital costs in patients with dysphagia were 27,347 DKK (3,677 EUR, 4,282 USD higher than patients without dysphagia at the hospital, and annual health care costs in the

  2. Direct healthcare cost of obesity in brazil: an application of the cost-of-illness method from the perspective of the public health system in 2011.

    Science.gov (United States)

    de Oliveira, Michele Lessa; Santos, Leonor Maria Pacheco; da Silva, Everton Nunes

    2015-01-01

    Obesity is a global public health problem and a risk factor for several diseases that financially impact healthcare systems. To estimate the direct costs attributable to obesity (body mass index {BMI} ≥ 30 kg/m2) and morbid obesity (BMI ≥ 40 kg/m2) in adults aged ≥ 20 incurred by the Brazilian public health system in 2011. Public hospitals and outpatient care. A cost-of-illness method was adopted using a top-down approach based on prevalence. The proportion of the cost of each obesity-associated comorbidity was calculated and obesity prevalence was used to calculate attributable risk. Direct healthcare cost data (inpatient care, bariatric surgery, outpatient care, medications and diagnostic procedures) were extracted from the Ministry of Health information systems, available on the web. Direct costs attributable to obesity totaled US$ 269.6 million (1.86% of all expenditures on medium- and high-complexity health care). The cost of morbid obesity accounted for 23.8% (US$ 64.2 million) of all obesity-related costs despite being 18 times less prevalent than obesity. Bariatric surgery costs in Brazil totaled US$ 17.4 million in 2011. The cost of morbid obesity in women was five times higher than it was in men. The cost of morbid obesity was found to be proportionally higher than the cost of obesity. If the current epidemic were not reversed, the prevalence of obesity in Brazil will increase gradually in the coming years, as well as its costs, having serious implications for the financial sustainability of the Brazilian public health system.

  3. Information and the Cost of Capital: An Ex Ante Perspective

    DEFF Research Database (Denmark)

    Christensen, Peter Ove; de la Rosa, Leonidas Enrique; Feltham, Gerald A.

    2010-01-01

    Recent articles have demonstrated that increased public disclosure can decrease firms' cost of capital. The focus has been on the impact of information on the cost of capital subsequent to the release of the information (the ex post cost of capital). We show that the reduction in the ex post cost...... investors may actually benefit from a higher ex post cost of capital....... of capital is offset by an equal increase in the cost of capital for the period leading up to the release of the information (the preposterior cost of capital). Thus, within the class of models framing the recent discussion, there is no impact on the ex ante cost of capital covering the full time span...

  4. Greater accordance with the Dietary Approaches to Stop Hypertension dietary pattern is associated with lower diet-related greenhouse gas production but higher dietary costs in the United Kingdom.

    Science.gov (United States)

    Monsivais, Pablo; Scarborough, Peter; Lloyd, Tina; Mizdrak, Anja; Luben, Robert; Mulligan, Angela A; Wareham, Nicholas J; Woodcock, James

    2015-07-01

    The Dietary Approaches to Stop Hypertension (DASH) diet is a proven way to prevent and control hypertension and other chronic disease. Because the DASH diet emphasizes plant-based foods, including vegetables and grains, adhering to this diet might also bring about environmental benefits, including lower associated production of greenhouse gases (GHGs). The objective was to examine the interrelation between dietary accordance with the DASH diet and associated GHGs. A secondary aim was to examine the retail cost of diets by level of DASH accordance. In this cross-sectional study of adults aged 39-79 y from the European Prospective Investigation into Cancer and Nutrition-Norfolk, United Kingdom cohort (n = 24,293), dietary intakes estimated from food-frequency questionnaires were analyzed for their accordance with the 8 DASH food and nutrient-based targets. Associations between DASH accordance, GHGs, and dietary costs were evaluated in regression analyses. Dietary GHGs were estimated with United Kingdom-specific data on carbon dioxide equivalents associated with commodities and foods. Dietary costs were estimated by using national food prices from a United Kingdom-based supermarket comparison website. Greater accordance with the DASH dietary targets was associated with lower GHGs. Diets in the highest quintile of accordance had a GHG impact of 5.60 compared with 6.71 kg carbon dioxide equivalents/d for least-accordant diets (P dietary costs, with the mean cost of diets in the top quintile of DASH scores 18% higher than that of diets in the lowest quintile (P < 0.0001). Promoting wider uptake of the DASH diet in the United Kingdom may improve population health and reduce diet-related GHGs. However, to make the DASH diet more accessible, food affordability, particularly for lower income groups, will have to be addressed.

  5. How much does it cost? The LIFE Project - Costing Models for Digital Curation and Preservation

    Directory of Open Access Journals (Sweden)

    Richard Davies

    2007-11-01

    Full Text Available Digital preservation is concerned with the long-term safekeeping of electronic resources. How can we be confident of their permanence, if we do not know the cost of preservation? The LIFE (Lifecycle Information for E-Literature Project has made a major step forward in understanding the long-term costs in this complex area. The LIFE Project has developed a methodology to model the digital lifecycle and to calculate the costs of preserving digital information for the next 5, 10 or 100 years. National and higher education (HE libraries can now apply this process and plan effectively for the preservation of their digital collections. Based on previous work undertaken on the lifecycles of paper-based materials, the LIFE Project created a lifecycle model and applied it to real-life digital collections across a diverse subject range. Three case studies examined the everyday operations, processes and costs involved in their respective activities. The results were then used to calculate the direct costs for each element of the digital lifecycle. The Project has made major advances in costing preservation activities, as well as making detailed costs of real digital preservation activities available. The second phase of LIFE (LIFE2, which recently started, aims to refine the lifecycle methodology and to add a greater range and breadth to the project with additional exemplar case studies.

  6. The hidden costs: Identification of indirect costs associated with acute gastrointestinal illness in an Inuit community

    Science.gov (United States)

    Vriezen, Rachael; Edge, Victoria L.; Ford, James; Wood, Michele; Harper, Sherilee

    2018-01-01

    Background Acute gastrointestinal illness (AGI) incidence and per-capita healthcare expenditures are higher in some Inuit communities as compared to elsewhere in Canada. Consequently, there is a demand for strategies that will reduce the individual-level costs of AGI; this will require a comprehensive understanding of the economic costs of AGI. However, given Inuit communities’ unique cultural, economic, and geographic contexts, there is a knowledge gap regarding the context-specific indirect costs of AGI borne by Inuit community members. This study aimed to identify the major indirect costs of AGI, and explore factors associated with these indirect costs, in the Inuit community of Rigolet, Canada, in order to develop a case-based context-specific study framework that can be used to evaluate these costs. Methods A mixed methods study design and community-based methods were used. Qualitative in-depth, group, and case interviews were analyzed using thematic analysis to identify and describe indirect costs of AGI specific to Rigolet. Data from two quantitative cross-sectional retrospective surveys were analyzed using univariable regression models to examine potential associations between predictor variables and the indirect costs. Results/Significance The most notable indirect costs of AGI that should be incorporated into cost-of-illness evaluations were the tangible costs related to missing paid employment and subsistence activities, as well as the intangible costs associated with missing community and cultural events. Seasonal cost variations should also be considered. This study was intended to inform cost-of-illness studies conducted in Rigolet and other similar research settings. These results contribute to a better understanding of the economic impacts of AGI on Rigolet residents, which could be used to help identify priority areas and resource allocation for public health policies and programs. PMID:29768456

  7. Societal costs of diabetes mellitus in Denmark

    DEFF Research Database (Denmark)

    Sortsø, C; Green, A; Jensen, Peter Bjødstrup

    2016-01-01

    AIM: To provide comprehensive real-world evidence on societal diabetes-attributable costs in Denmark. METHODS: National register data are linked on an individual level through unique central personal registration numbers in Denmark. All patients in the Danish National Diabetes Register in 2011 (N...... = 318 729) were included in this study. Complication status was defined according to data from the Danish National Hospital Register. Diabetes-attributable costs were calculated as the difference between costs of patients with diabetes and the expected costs given the annual resource consumption...... of the diabetes-free population. RESULTS: Societal costs attributable to diabetes were estimated to be at least 4.27 billion EUR in 2011, corresponding to 14,349 EUR per patient-year. A twofold higher healthcare resource usage was found for patients with diabetes as compared with the diabetes-free population...

  8. Costs and cost-effectiveness of carotid stenting versus endarterectomy for patients at standard surgical risk: results from the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST).

    Science.gov (United States)

    Vilain, Katherine R; Magnuson, Elizabeth A; Li, Haiyan; Clark, Wayne M; Begg, Richard J; Sam, Albert D; Sternbergh, W Charles; Weaver, Fred A; Gray, William A; Voeks, Jenifer H; Brott, Thomas G; Cohen, David J

    2012-09-01

    The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) demonstrated similar rates of the primary composite end point between carotid artery stenting (CAS) and carotid endarterectomy (CEA), although the risk of stroke was higher with CAS, and the risk of myocardial infarction was higher with CEA. Given the large number of patients who are candidates for these procedures, an understanding of their relative cost and cost-effectiveness may have important implications for health care policy and treatment guidelines. We performed a formal economic evaluation alongside the CREST trial. Costs were estimated from all trial participants over the first year of follow-up using a combination of resource use data and hospital billing data. Patient-level health use scores were obtained using data from the SF-36. We then used a Markov disease-simulation model calibrated to the CREST results to project 10-year costs and quality-adjusted life expectancy for the 2 treatment groups. Although initial procedural costs were $1025/patient higher with CAS, postprocedure costs and physician costs were lower such that total costs for the index hospitalization were similar for the CAS and CEA groups ($15 055 versus $14 816; mean difference, $239/patient; 95% CI for difference, -$297 to $775). Neither follow-up costs after discharge nor total 1-year costs differed significantly. For the CREST population, model-based projections over a 10-year time horizon demonstrated that CAS would result in a mean incremental cost of $524/patient and a reduction in quality-adjusted life expectancy of 0.008 years compared with CEA. Probabilistic sensitivity analysis demonstrated that CEA was economically attractive at an incremental cost-effectiveness threshold of $50 000/quality-adjusted life-year gained in 54% of samples, whereas CAS was economically attractive in 46%. Despite slightly lower in-trial costs and lower rates of stroke with CEA compared with CAS, projected 10-year outcomes

  9. Negotiated Settlements: Long-term Profits and Costs

    Directory of Open Access Journals (Sweden)

    G. Kent Fellows

    2012-05-01

    Full Text Available Over the last 20 years, utility regulators have relaxed their oversight of cost-ofservice regulation and this holds true for Alberta, where such regulation determines the fees associated with oil and gas pipeline usage. The traditional method has been for regulators to issue binding decisions on a firm’s cost of service after taking evidence at a formal hearing. Many regulators now prefer to encourage parties to settle a cost-of-service agreement through a negotiated settlement, which the regulator then approves. This process not only saves the cost of a hearing, it also permits firms and consumers to trade costs and benefits, settling on a final price more favourable to both. The author details how this arrangement can negatively impact future consumers by allowing the firm to defer the true burden of its depreciation expenses in return for inflated capital costs. Such a settlement lowers prices for the present but saddles future consumers with higher prices.

  10. A randomized controlled trial of intensive care management for disabled Medicaid beneficiaries with high health care costs.

    Science.gov (United States)

    Bell, Janice F; Krupski, Antoinette; Joesch, Jutta M; West, Imara I; Atkins, David C; Court, Beverly; Mancuso, David; Roy-Byrne, Peter

    2015-06-01

    To evaluate outcomes of a registered nurse-led care management intervention for disabled Medicaid beneficiaries with high health care costs. Washington State Department of Social and Health Services Client Outcomes Database, 2008-2011. In a randomized controlled trial with intent-to-treat analysis, outcomes were compared for the intervention (n = 557) and control groups (n = 563). A quasi-experimental subanalysis compared outcomes for program participants (n = 251) and propensity score-matched controls (n = 251). Administrative data were linked to describe costs and use of health services, criminal activity, homelessness, and death. In the intent-to-treat analysis, the intervention group had higher odds of outpatient mental health service use and higher prescription drug costs than controls in the postperiod. In the subanalysis, participants had fewer unplanned hospital admissions and lower associated costs; higher prescription drug costs; higher odds of long-term care service use; higher drug/alcohol treatment costs; and lower odds of homelessness. We found no health care cost savings for disabled Medicaid beneficiaries randomized to intensive care management. Among participants, care management may have the potential to increase access to needed care, slow growth in the number and therefore cost of unplanned hospitalizations, and prevent homelessness. These findings apply to start-up care management programs targeted at high-cost, high-risk Medicaid populations. © Health Research and Educational Trust.

  11. Passenger vehicles that minimize the costs of ownership and environmental damages in the Indian market

    International Nuclear Information System (INIS)

    Gilmore, Elisabeth A.; Patwardhan, Anand

    2016-01-01

    Highlights: • Full costs (private and social) are evaluated for Indian passenger cars. • Diesel has low ownership costs, but higher climate and health damages. • Compressed natural gas cars have lower costs and damages than petrol cars. • Electric cars have higher damages due to electricity generation emissions. • CNG and less carbon intensive electricity minimizes Indian cars’ full cost. - Abstract: Rapid expansion of population and income growth in developing countries, such as India, is increasing the demand for many goods and services, including four-wheeled passenger cars. Passenger cars provide personal mobility; however, they also have negative implications for human wellbeing from increased air pollutants and greenhouse gases (GHG). Here, we evaluate the range of passenger vehicles available in the Indian market to identify options that minimize costs, human health effects and climate damages. Our approach is to compare alternative fuel/powertrain vehicles with similar conventional gasoline fueled vehicles and assess the differences in full (private and societal) costs for each pair. Private costs are the combination of capital costs and the discounted expected future fuel costs over the vehicle lifetime. The costs to human health from air quality are calculated using intake fractions to estimate exposure and literature values for the damage costs adjusted by benefits transfer methods. We use the Social Cost of Carbon to estimate climate damages. We find that, on average, the net present value (NPV) of the full costs of compressed natural gas (CNG) vehicles are lower than comparable gasoline vehicles, while, diesel vehicles have higher costs. Presently, electric vehicles have higher private costs (due to high capital costs) and societal costs (due to electricity generation emissions). Either a less carbon intensive electricity grid or an increase in the CNG fleet would minimize total costs, human health effects and GHG emissions from the

  12. Perineal tap water burns in the elderly: at what cost?

    Science.gov (United States)

    Potter, Michael D E; Maitz, Peter K M; Kennedy, Peter J; Goltsman, David

    2017-11-01

    Burn injuries are expensive to treat. Burn injuries have been found to be difficult to treat in elderly patients than their younger counterparts. This is likely to result in higher financial burden on the healthcare system; however, no population-specific study has been conducted to ascertain the inpatient treatment costs of elderly patients with hot tap water burns. Six elderly patients (75-92 years) were admitted for tap water burns at Concord Hospital during 2010. All costs incurred during their hospitalization were followed prospectively, and were apportioned into 'direct' and 'indirect' costs. Direct costs encompassed directly measurable costs, such as consumables used on the ward or in theatres, and indirect costs included hospital overheads, such as bed and theatre costs. Three males and three females admitted with burns to the buttocks, legs or feet. Total burn surface area (TBSA) ranged from 9-21% (mean 12.8%). Length of stay ranged from 26-98 days (mean 46 days). One patient died, and four required surgical management or grafting. Total inpatient costs ranged from $69 782.33 to $254 652.70 per patient (mean $122 800.20, standard deviation $67 484.46). TBSA was directly correlated with length of stay (P < 0.01) and total cost (P < 0.01). Hot water burns among the elderly are associated with high treatment costs, which are proportional to the size of the burn. The cost of treating this cohort is higher than previously reported in a general Australian burn cohort. © 2016 Royal Australasian College of Surgeons.

  13. Life cycle cost and risk estimation of environmental management options

    International Nuclear Information System (INIS)

    Shropshire, D.; Sherick, M.

    1996-01-01

    The evaluation process is demonstrated in this paper through comparative analysis of two alternative scenarios identified for the management of the alpha-contaminated fixed low-level waste currently stored at INEL. These two scenarios, the Base Case and the Delay Case, are realistic and based on actual data, but are not intended to exactly match actual plans currently being developed at INEL. Life cycle cost estimates were developed for both scenarios using the System Cost Model; resulting costs are presented and compared. Life cycle costs are shown as a function of time and also aggregated by pretreatment, treatment, storage, and disposal activities. Although there are some short-term cost savings for the Delay Case, cumulative life cycle costs eventually become much higher than costs for the Base Case over the same period of time, due mainly to the storage and repackaging necessary to accommodate the longer Delay Case schedule. Life cycle risk estimates were prepared using a new risk analysis method adapted to the System Cost Model architecture for automated, systematic cost/risk applications. Relative risk summaries are presented for both scenarios as a function of time and also aggregated by pretreatment, treatment, storage, and disposal activities. Relative risk of the Delay Case is shown to be higher than that of the Base Case. Finally, risk and cost results are combined to show how the collective information can be used to help identify opportunities for risk or cost reduction and highlight areas where risk reduction can be achieved most economically

  14. [Cost at the first level of care].

    Science.gov (United States)

    Villarreal-Ríos, E; Montalvo-Almaguer, G; Salinas-Martínez, M; Guzmán-Padilla, J E; Tovar-Castillo, N H; Garza-Elizondo, M E

    1996-01-01

    To estimate the unit cost of 15 causes of demand for primary care per health clinic in an institutional (social security) health care system, and to determine the average cost at the state level. The cost of 80% of clinic visits was estimated in 35 of 40 clinics in the social security health care system in the state of Nuevo Leon, Mexico. The methodology for fixed costs consisted of: departmentalization, inputs, cost, weights and construction of matrices. Variable costs were estimated for standard patients by type of health care sought and with the consensus of experts; the sum of fixed and variable costs gave the unit cost. A computerized model was employed for data processing. A large variation in unit cost was observed between health clinics studied for all causes of demand, in both metropolitan and non-metropolitan areas. Prenatal care ($92.26) and diarrhea ($93.76) were the least expensive while diabetes ($240.42) and hypertension ($312.54) were the most expensive. Non-metropolitan costs were higher than metropolitan costs (p < 0.05); controlling for number of physician's offices showed that this was determined by medical units with only one physician's office. Knowledge of unit costs is a tool that, when used by medical administrators, allows adequate health care planning and efficient allocation of health resources.

  15. Cost overruns and demand shortfalls - Deception or selection?

    DEFF Research Database (Denmark)

    Eliasson, Jonas; Fosgerau, Mogens

    2013-01-01

    whether to implement projects. Using a database of projects we present examples indicating that the selection bias may be substantial. The examples also indicate that benefit-cost ratios remain a useful selection criterion even when cost and benefits are highly uncertain, gainsaying the argument......A number of highly cited papers by Flyvbjerg and associates have shown that ex ante infrastructure appraisals tend to be overly optimistic. Ex post evaluations indicate a bias where investment costs are higher and benefits lower on average than predicted ex ante. These authors argue that the bias...... that such uncertainties render cost-benefit analyses useless. © 2013 Elsevier Ltd....

  16. The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation

    Science.gov (United States)

    Doran, Tim; Cookson, Richard

    2016-01-01

    Background There are substantial socioeconomic inequalities in both life expectancy and healthcare use in England. In this study, we describe how these two sets of inequalities interact by estimating the social gradient in hospital costs across the life course. Methods Hospital episode statistics, population and index of multiple deprivation data were combined at lower-layer super output area level to estimate inpatient hospital costs for 2011/2012 by age, sex and deprivation quintile. Survival curves were estimated for each of the deprivation groups and used to estimate expected annual costs and cumulative lifetime costs. Results A steep social gradient was observed in overall inpatient hospital admissions, with rates ranging from 31 298/100 000 population in the most affluent fifth of areas to 43 385 in the most deprived fifth. This gradient was steeper for emergency than for elective admissions. The total cost associated with this inequality in 2011/2012 was £4.8 billion. A social gradient was also observed in the modelled lifetime costs where the lower life expectancy was not sufficient to outweigh the higher average costs in the more deprived populations. Lifetime costs for women were 14% greater than for men, due to higher costs in the reproductive years and greater life expectancy. Conclusions Socioeconomic inequalities result in increased morbidity and decreased life expectancy. Interventions to reduce inequality and improve health in more deprived neighbourhoods have the potential to save money for health systems not only within years but across peoples’ entire lifetimes, despite increased costs due to longer life expectancies. PMID:27189975

  17. Chronic Disease Cost not Transferable: Colombian Reality

    Directory of Open Access Journals (Sweden)

    Karina Gallardo Solarte

    2016-01-01

    Full Text Available Objective: The aim is to reflect on the social and economic costs of chronic non-communicable disease (NCD in Colombia to display a charging indicator of these pathologies. Material and methods: In a review of 50 studies, 27 were selected since these met the inclusion criteria, like chronical disease, studies conducted between 2002 and 2011 related to costs, chronic disease, and being Colombian. Results: This is a review study of chronic diseases vs. their costs, being here cardiovascular diseases part of the group of high cost and higher incidence diseases, thus repre­senting a great risk to the financial stability of healthcare companies. There are few studies that address the costs generated by the treatment of ncds patients that show the economic impact experienced by public and private institutions providing and promoting health services. Most of them forget the economic, family and social costs the affected population must suffer. Conclu­sions: ncds represent a burden to the health service system for their very high costs, untimely intervention and reduced significant benefit for this population and their families.

  18. Monetary Diet Cost, Diet Quality, and Parental Socioeconomic Status in Spanish Youth.

    Directory of Open Access Journals (Sweden)

    Helmut Schröder

    Full Text Available Using a food-based analysis, healthy dietary patterns in adults are more expensive than less healthy ones; studies are needed in youth. Therefore, the objective of the present study was to determine relationships between monetary daily diet cost, diet quality, and parental socioeconomic status.Data were obtained from a representative national sample of 3534 children and young people in Spain, aged 2 to 24 years. Dietary assessment was performed with a 24-hour recall. Mediterranean diet adherence was measured by the KIDMED questionnaire. Average food cost was calculated from official Spanish government data. Monetary daily diet cost was expressed as euros per day (€/d and euros per day standardized to a 1000kcal diet (€/1000kcal/d.Mean monetary daily diet cost was 3.16±1.57€/d (1.56±0.72€/1000kcal/d. Socioeconomic status was positively associated with monetary daily diet cost and diet quality measured by the KIDMED index (€/d and €/1000kcal/d, p<0.019. High Mediterranean diet adherence (KIDMED score 8-12 was 0.71 €/d (0.28€/1000kcal/d more expensive than low compliance (KIDMED score 0-3. Analysis for nonlinear association between the KIDMED index and monetary daily diet cost per1000kcal showed no further cost increases beyond a KIDMED score of 8 (linear p<0.001; nonlinear p = 0.010.Higher monetary daily diet cost is associated with healthy eating in Spanish youth. Higher socioeconomic status is a determinant for higher monetary daily diet cost and quality.

  19. Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing.

    Science.gov (United States)

    Bauer-Nilsen, Kristine; Hill, Colin; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

    2018-01-01

    To evaluate the delivery costs, using time-driven activity-based costing, and reimbursement for definitive radiation therapy for locally advanced cervical cancer. Process maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information, and facilities costs were also obtained. We defined the capacity cost rate (CCR) for each resource and then calculated the total cost of patient care according to CCR and time for each resource. Costs were compared with 2016 Medicare reimbursement and relative value units (RVUs). The total cost of radiation therapy for cervical cancer was $12,861.68, with personnel costs constituting 49.8%. Brachytherapy cost $8610.68 (66.9% of total) and consumed 423 minutes of attending radiation oncologist time (80.0% of total). External beam radiation therapy cost $4055.01 (31.5% of total). Personnel costs were higher for brachytherapy than for the sum of simulation and external beam radiation therapy delivery ($4798.73 vs $1404.72). A full radiation therapy course provides radiation oncologists 149.77 RVUs with intensity modulated radiation therapy or 135.90 RVUs with 3-dimensional conformal radiation therapy, with total reimbursement of $23,321.71 and $16,071.90, respectively. Attending time per RVU is approximately 4-fold higher for brachytherapy (5.68 minutes) than 3-dimensional conformal radiation therapy (1.63 minutes) or intensity modulated radiation therapy (1.32 minutes). Time-driven activity-based costing was used to calculate the total cost of definitive radiation therapy for cervical cancer, revealing that brachytherapy delivery and personnel resources constituted the majority of costs. However, current reimbursement policy does not reflect the increased attending physician effort and delivery costs of brachytherapy. We

  20. Cost and cost-effectiveness of smear-positive tuberculosis treatment by Health Extension Workers in Southern Ethiopia: a community randomized trial.

    Directory of Open Access Journals (Sweden)

    Daniel G Datiko

    Full Text Available UNLABELLED: Treatments by HEWs in the health posts and general health workers at health facility were compared along a community-randomized trial. Costs were analysed from societal perspective in 2007 in US $ using standard methods. We prospectively enrolled smear positive patients, and calculated cost-effectiveness as the cost per patient successfully treated. The total cost for each successfully treated smear-positive patient was higher in health facility ($158.9 compared with community ($61.7. Community-based treatment reduced the total, patient and caregiver cost by 61.2%, 68.1% and 79.8%, respectively. Involving HEWs added a total cost of $8.80 (14.3% of total cost on health service per patient treated in the community. CONCLUSIONS/SIGNIFICANCE: Community-based treatment by HEWs costs only 39% of what treatment by general health workers costs for similar outcomes. Involving HEWs in TB treatment is a cost effective treatment alternative to the health service, to the patients and the family. There is an economic and public health reason to consider involving HEWs in TB treatment in Ethiopia. However, community-based treatment requires initial investment to start its implementation, training and supervision. TRIAL REGISTRATION: ClinicalTrials.gov NCT00803322.

  1. Proton therapy of cancer: Potential clinical advantages and cost-effectiveness

    International Nuclear Information System (INIS)

    Lundkvist, Jonas; Ekman, Mattias; Rehn Ericsson, Suzanne; Glimelius, Bengt; Akademiska sjukhuset, Uppsala

    2005-01-01

    Proton therapy may offer potential clinical advantages compared with conventional radiation therapy for many cancer patients. Due to the large investment costs for building a proton therapy facility, however, the treatment cost with proton radiation is higher than with conventional radiation. It is therefore important to evaluate whether the medical benefits of proton therapy are large enough to motivate the higher costs. We assessed the cost-effectiveness of proton therapy in the treatment of four different cancers: left-sided breast cancer, prostate cancer, head and neck cancer, and childhood medulloblastoma. A Markov cohort simulation model was created for each cancer type and used to simulate the life of patients treated with radiation. Cost and quality adjusted life years (QALYs) were used as primary outcome measures. The results indicated that proton therapy was cost-effective if appropriate risk groups were chosen. The average cost per QALY gained for the four types of cancer assessed was about Euro 10,130. If the value of a QALY was set to Euro 55,000, the total yearly net benefit of treating 925 cancer patients with the four types of cancer was about Euro 20.8 million. Investment in a proton facility may thus be cost-effective. The results must be interpreted with caution, since there is a lack of data, and consequently large uncertainties in the assumptions used

  2. The impact of feedstock cost on technology selection and optimum size

    International Nuclear Information System (INIS)

    Cameron, Jay B.; Kumar, Amit; Flynn, Peter C.

    2007-01-01

    Development of biomass projects at optimum size and technology enhances the role that biomass can make in mitigating greenhouse gas. Optimum sized plants can be built when biomass resources are sufficient to meet feedstock demand; examples include wood and forest harvest residues from extensive forests, and grain straw and corn stover from large agricultural regions. The impact of feedstock cost on technology selection is evaluated by comparing the cost of power from the gasification and direct combustion of boreal forest wood chips. Optimum size is a function of plant cost and the distance variable cost (DVC, $ dry tonne -1 km -1 ) of the biomass fuel; distance fixed costs (DFC, $ dry tonne -1 ) such as acquisition, harvesting, loading and unloading do not impact optimum size. At low values of DVC and DFC, as occur with wood chips sourced from the boreal forest, direct combustion has a lower power cost than gasification. At higher values of DVC and DFC, gasification has a lower power cost than direct combustion. This crossover in most economic technology will always arise when a more efficient technology with a higher capital cost per unit of output is compared to a less efficient technology with a lower capital cost per unit of output. In such cases technology selection cannot be separated from an analysis of feedstock cost

  3. Leading the Charge: Governors, Higher Education and Accountability

    Science.gov (United States)

    American Council of Trustees and Alumni, 2014

    2014-01-01

    With this new tool, ACTA [American Council of Trustees and Alumni] is working to expand its outreach to governors nationwide on behalf of higher education reform, focusing on key issues of quality, cost, and accountability. ACTA has worked with governors and education leaders from across the country, and that experience has proven that innovative…

  4. A societal cost-of-illness study of hemodialysis in Lebanon.

    Science.gov (United States)

    Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Salameh, Pascale; Evers, Silvia M A A

    2016-12-01

    Renal failure is a growing public health problem, and is mainly treated by hemodialysis. This study aims to estimate the societal costs of hemodialysis in Lebanon. This was a quantitative, cross-sectional cost-of-illness study conducted alongside the Nutrition Education for Management of Osteodystrophy trial. Costs were assessed with a prevalence-based, bottom-up approach, for the period of June-December 2011. The data of 114 patients recruited from six hospital-based units were collected through a questionnaire measuring healthcare costs, costs to patients and family, and costs in other sectors. Recall data were used for the base-case analysis. Sensitivity analyses employing various sources of resources use and costs were performed. Costs were uprated to 2015US$. Multiple linear regression was conducted to explore the predictors of societal costs. The mean 6-month societal costs were estimated at $9,258.39. The larger part was attributable to healthcare costs (91.7%), while costs to patient and family and costs in other sectors poorly contributed to the total costs (4.2% and 4.1%, respectively). In general, results were robust to sensitivity analyses. Using the maximum value for hospitalization resulted in the biggest difference (+15.5% of the base-case result). Female gender, being widowed/divorced, having hypertension comorbidity, and higher weekly time on dialysis were significantly associated with greater societal costs. Information regarding resource consumption and cost were not readily available. Rather, they were obtained from a variety of sources, with each having its own strengths and limitations. Hemodialysis represents a high societal burden in Lebanon. Using extrapolation, its total annual cost for the Lebanese society is estimated at $61,105,374 and the mean total annual cost ($18,516.7) is 43.70% higher than the gross domestic product per capita forecast for 2015. Measures to reduce the economic burden of hemodialysis should be taken, by promoting

  5. Price Reversal Pattern of ARV Drugs: A Transaction-Cost Approach Digression

    Directory of Open Access Journals (Sweden)

    Frank LORNE

    2015-05-01

    Full Text Available A price reversal pattern of ARV drugs was noted across lower and middle income countries in that the lower-income countries have higher prices relative to higher-income countries based on a 2008-2009 Summary Report by World Health Organization. The transaction costs affecting AVR drug pricing can be broadly classified into two kinds: One between the final users and the opinion/knowledge experts, and the other between the opinion/knowledge experts and the manufacturers. Economist’s version of price discrimination needs to be modified by including transaction costs. Transaction costs also point to institution creditability factors that will affect NGO procurement.

  6. Frequency and Costs of Communication with Citizens in Local Government

    DEFF Research Database (Denmark)

    Andersen, Kim Normann; Medaglia, Rony; Zinner Henriksen, Helle

    2011-01-01

    This paper addresses the frequency and costs of local governmentcitizen communication in five channels (physical meetings, postal mails, phone calls, e-mail and online self service. Considered to be among the advanced countries with regards to supply of e-services, our analysis shows a surprisingly...... low use of transactions in the Danish local government. Also, our estimate is that email costs are higher than phone call costs and that there is substantial room for advancing our knowledge of the costs of e-services....

  7. Cost Benefit Analysis of Khaddar Industry: a Study on Comilla District

    Directory of Open Access Journals (Sweden)

    Shamimul Islam

    2015-01-01

    Full Text Available The study tries to findout the Cost Benefit Analysis (CBA of Khaddar industry. Comilla district is considered as the study area. Sample is selected purposively based on the stablishment available within the district. The collected data is analysed by using Microsoft Office Excel 2007 to calculate different statistical values used in this paper. All the possible techniques of Cost Benefit analysis are employed. The findings suggest that, in both the cases i.e., in case of Hand Loom as well as in case of Power Loom the expected return is very high. The value of Net Present Value (NPV, Benefit Cost Ratio (BCR and Internal Rate of Return (IRR suggest that, there is a very higher profitability in this sector. The IRR of the projects is 183 and 157 for Hand Loom and Power Loom respectively which is exceptionally very high. The higher value may due to low establishment costs and low maintenance costs for hand loom alternatively high productivity and comparatively lower operating costs for power loom industries.

  8. Bearing Procurement Analysis Method by Total Cost of Ownership Analysis and Reliability Prediction

    Science.gov (United States)

    Trusaji, Wildan; Akbar, Muhammad; Sukoyo; Irianto, Dradjad

    2018-03-01

    In making bearing procurement analysis, price and its reliability must be considered as decision criteria, since price determines the direct cost as acquisition cost and reliability of bearing determine the indirect cost such as maintenance cost. Despite the indirect cost is hard to identify and measured, it has high contribution to overall cost that will be incurred. So, the indirect cost of reliability must be considered when making bearing procurement analysis. This paper tries to explain bearing evaluation method with the total cost of ownership analysis to consider price and maintenance cost as decision criteria. Furthermore, since there is a lack of failure data when bearing evaluation phase is conducted, reliability prediction method is used to predict bearing reliability from its dynamic load rating parameter. With this method, bearing with a higher price but has higher reliability is preferable for long-term planning. But for short-term planning the cheaper one but has lower reliability is preferable. This contextuality can give rise to conflict between stakeholders. Thus, the planning horizon needs to be agreed by all stakeholder before making a procurement decision.

  9. Understanding the costs and schedule of hydroelectric projects

    International Nuclear Information System (INIS)

    Merrow, E.W.; Schroeder, B.R.

    1991-01-01

    This paper is based on a study conducted for the World Bank which evaluated the feasibility of developing an empirically based ex ante project analysis system for hydroelectric projects. The system would be used to assess: the reasonableness of engineering-based cost and schedule estimates used for project appraisal and preliminary estimates used to select projects for appraisal; and the potential for cost growth and schedule slip. The system would help identify projects early in the project appraisal process that harbor significantly higher than normal risks of overrunning cost and schedule estimates

  10. Activity-Based Management System Implementation in Higher Education Institution: Benefits and Challenges

    Science.gov (United States)

    Ismail, Noor Azizi

    2010-01-01

    Purpose: The purpose of this paper is to discuss how activity-based costing (ABC) technique can be applied in the context of higher education institutions. It also discusses the obstacles and challenges to the successful implementation of activity-based management (ABM) in the higher education environment. Design/methodology/approach: This paper…

  11. Nuclear operating costs are rising exponentially - official

    International Nuclear Information System (INIS)

    Thomas, S.

    1988-01-01

    The Energy Information Agency of the United States Department of Energy has collected data on the operations of nuclear power plants in the United States. A statistical regression analysis was made of this data base. This shows that the escalation in annual, real non-fuel operating costs is such that the operating cost savings made by closing down an old nuclear plant would be sufficient to pay the capital and operating costs of replacing it with a brand new coal-fired plant. The main reason for the increasing operating and maintenance costs is the cost of replacement power i.e. the higher the economic penalty of plant breakdown the more the utility has to spend on maintenance. Another reason is time -not the age of the plant - but the year the data was collected. The economic case for nuclear power is seriously challenged. (U.K.)

  12. The impact of healthcare costs in the last year of life and in all life years gained on the cost-effectiveness of cancer screening

    DEFF Research Database (Denmark)

    de Kok, I M C M; Polder, J J; Habbema, J D F

    2009-01-01

    life year. We calculated the change in cost-effectiveness ratios (CERs) if unrelated healthcare costs in the LastYL or in LYsG would be included. Costs in the LastYL were on average 33% higher for persons dying from cancer than from any cause. Including costs in LysG increased the CER by 4040 euro...... in women, and by 4100 euro in men. Of these, 660 euro in women, and 890 euro in men, were costs in the LastYL. Including unrelated healthcare costs in the LastYL or in LYsG will change the comparative cost-effectiveness of healthcare programmes. The CERs of cancer screening programmes will clearly increase......, with approximately 4000 euro. However, because of the favourable CER's, including unrelated healthcare costs will in general have limited policy implications....

  13. The cost of engineered disposal facilities

    International Nuclear Information System (INIS)

    Mallory, C.W.; Razor, J.E.; Mills, D.

    1987-01-01

    An improved disposal trench was designed, constructed and placed into operation at the Maxey Flats Disposal Site during the period April 1985 through July 1986. With the improved trench design, the waste packages are placed in clusters and the surrounding space is filled with gravel and grouted with a sand/cement mixture to form walls and cells that surround the waste package. The walls provide structural support for a poly-ethylene reinforced soil beam which in turn supports a multi-layer protective cap. About 2,700 drums of waste (20,250 CF) were placed into the trench. The total cost of the improved trench was $193,500 and the unit cost was $9.56 per cubic foot not including the placement of the waste. The engineered features of the trench (i.e., sidewall infiltration barrier, grout backfill and the soil beam) cost $82,600 for a unit cost of $4.08 per cubic foot of waste. This is compared to the cost of concrete cannisters used for radioactive waste disposal. On a production basis the cannisters are estimated to cost about $1,260. Depending upon the type waste, the cost of the cannisters will range from $2 to $12 per cubic foot of waste. The slightly higher cost of the concrete cannisters is offset by certain performance advantages

  14. Issues in Moroccan Higher Education

    Directory of Open Access Journals (Sweden)

    Mohammed Lazrak

    2017-06-01

    Full Text Available Historically, education has always been the springboard for socio-economic development of nations. Undoubtedly, education proved to be the catalyst of change and the front wagon that drives with it all the other wagons pertaining to other dynamic sectors. In effect, the role of education can be seen to provide pupils with the curriculum and hidden curriculum skills alike; teaching skills that will prepare them physically, mentally and socially for the world of work in later life. In Morocco, the country spends over 26% of its Gross Domestic Product (GDP on education. Unfortunately, though this number is important, Moroccan education (primary, secondary and higher education alike still suffers from the mismatch between the state expenditures on education and the general product in reality. In this article, an attempt is made to touch on some relevant issues pertaining to higher education with special reference to Morocco. First, it provides some tentative definitions, mission and functions of university and higher education. Second, it gives a historical sketch of the major reforms that took place in Morocco as well as the major changes pertaining to these reforms respectively. Third, it provides a general overview of the history of higher education in Morocco, it also tackles an issue related to governance in higher education which is cost sharing. Fourth, it delves into the history of English Language Teaching (ELT, lists some characteristics of the English Departments in Morocco. Fifth, it discusses the issue of private vs. public higher education. Last, but not least, it tackles the issue of Brain Drain.

  15. Costs of treating patients with schizophrenia who have illness-related crisis events

    Directory of Open Access Journals (Sweden)

    Peng Xiaomei

    2008-08-01

    Full Text Available Abstract Background Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Methods Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18, psychiatric hospitalization in the past 6 months (n = 240, arrest in the past 6 months (n = 56, violent behaviors in the past 4 weeks (n = 62, and diagnosis of a co-occurring substance use disorder (n = 413. Results Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024, followed by persons with psychiatric hospitalization in

  16. Fuel ethanol from cane molasses in Thailand: Environmental and cost performance

    International Nuclear Information System (INIS)

    Nguyen, Thu Lan T.; Gheewala, Shabbir H.

    2008-01-01

    In the context of the world's energy crisis and environmental concerns, crop-based ethanol has emerged as an energy alternative, the use of which can help reduce oil imports as well as emissions of CO 2 and other air pollutants. However, a clear disadvantage of ethanol is its high cost over gasoline under the current pricing scheme that does not include externalities. The intent of this study is to perform a life cycle analysis comparing environmental and cost performance of molasses-based E10 with those of CG. The results show that although E10 provides reduction in fossil energy use, petroleum use, CO 2 and NO x emissions, its total social costs are higher than those of gasoline due to higher direct production costs and external costs for other air emissions, e.g. CH 4 , N 2 O, CO, SO 2 , VOC and PM 10 . An analysis of projection scenarios shows that technological innovations towards cleaner production help maximize ethanol's benefits whilst minimizing its limitations

  17. Total life-cycle cost analysis of conventional and alternative fueled vehicles

    International Nuclear Information System (INIS)

    Cardullo, M.W.

    1993-01-01

    Total Life-Cycle Cost (TLCC) Analysis can indicate whether paying higher capital costs for advanced technology with low operating and/or environmental costs is advantageous over paying lower capital costs for conventional technology with higher operating and/or environmental costs. While minimizing total life-cycle cost is an important consideration, the consumer often identifies non-cost-related benefits or drawbacks that make more expensive options appear more attractive. The consumer is also likely to heavily weigh initial capital costs while giving limited consideration to operating and/or societal costs, whereas policy-makers considering external costs, such as those resulting from environmental impacts, may reach significantly different conclusions about which technologies are most advantageous to society. This paper summarizes a TLCC model which was developed to facilitate consideration of the various factors involved in both individual and societal policy decision making. The model was developed as part of a US Department of Energy Contract and has been revised to reflect changes necessary to make the model more realistic. The model considers capital, operating, salvage, and environmental costs for cars, vans, and buses using conventional and alternative fuels. The model has been developed to operate on an IBM or compatible personal computer platform using the commercial spreadsheet program MicroSoft Excell reg-sign Version 4 for Windows reg-sign and can be easily kept current because its modular structure allows straightforward access to embedded data sets for review and update

  18. The role of capital costs in decarbonizing the electricity sector

    Science.gov (United States)

    Hirth, Lion; Steckel, Jan Christoph

    2016-11-01

    Low-carbon electricity generation, i.e. renewable energy, nuclear power and carbon capture and storage, is more capital intensive than electricity generation through carbon emitting fossil fuel power stations. High capital costs, expressed as high weighted average cost of capital (WACC), thus tend to encourage the use of fossil fuels. To achieve the same degree of decarbonization, countries with high capital costs therefore need to impose a higher price on carbon emissions than countries with low capital costs. This is particularly relevant for developing and emerging economies, where capital costs tend to be higher than in rich countries. In this paper we quantitatively evaluate how high capital costs impact the transformation of the energy system under climate policy, applying a numerical techno-economic model of the power system. We find that high capital costs can significantly reduce the effectiveness of carbon prices: if carbon emissions are priced at USD 50 per ton and the WACC is 3%, the cost-optimal electricity mix comprises 40% renewable energy. At the same carbon price and a WACC of 15%, the cost-optimal mix comprises almost no renewable energy. At 15% WACC, there is no significant emission mitigation with carbon pricing up to USD 50 per ton, but at 3% WACC and the same carbon price, emissions are reduced by almost half. These results have implications for climate policy; carbon pricing might need to be combined with policies to reduce capital costs of low-carbon options in order to decarbonize power systems.

  19. Comparison of clinical outcome and costs with CC + gonadotropins and gnrha + gonadotropins during Ivf/ICSI cycles.

    Science.gov (United States)

    Kovacs, Peter; Matyas, Szabolcs; Bernard, l Artur; Kaali, Steven G

    2004-06-01

    To compare clinical outcome and costs of CC + gonadotropins with GnRHa + gonadotropins during IVF/ICSI cycles. Clinical outcome and expenses of 382 CC + gonadotropin and 964 GnRHa + gonadotropin cycles were compared. Medication costs were calculated on the basis of the mean number of ampoules and the proportion of various gonadotropins. Costs per clinical pregnancy were calculated on the basis of expenses and clinical pregnancy rates. Women in the CC + gonadotropin group were younger, and had fewer follicles, oocytes, embryos, and embryos transferred. Clinical pregnancy rates were higher in the GnRHa group (35.9 % vs 26.2%, p costs per cycle were higher in the GnRHa group (US dollars 357 vs 248). Expenses per pregnancy however were lower in the GnRHa group (USdollars 4197 vs 5335 with IVF; USdollars 5590 vs 7244 with ICSI). When different age subgroups with similar baseline characteristics and stimulation parameters were compared, pregnancy rates were significantly higher in the GnRHa groups. Medication cost per cycle was higher in the GnRHa subgroups, and the expense per pregnancy was lower with GnRHa protocol. Cost per cycle is higher with GnRHa + gonadotropin. However, because of the better performance of the GnRHa + gonadotropin stimulation, the cumulative costs are reduced by the time a clinical pregnancy is achieved.

  20. Direct and indirect costs of surgically treated pelvic fractures.

    Science.gov (United States)

    Aprato, Alessandro; Joeris, Alexander; Tosto, Ferdinando; Kalampoki, Vasiliki; Stucchi, Alessandro; Massè, Alessandro

    2016-03-01

    Pelvic fractures requiring surgical fixation are rare injuries but present a great societal impact in terms of disability, as well as economic resources. In the literature, there is no description of these costs. Main aim of this study is to describe the direct and indirect costs of these fractures. Secondary aims were to test if the type of fracture (pelvic ring injury or acetabular fracture) influences these costs (hospitalization, consultation, medication, physiotherapy sessions, job absenteeism). We performed a retrospective study on patients with surgically treated acetabular fractures or pelvic ring injuries. Medical records were reviewed in terms of demographic data, follow-up, diagnosis (according to Letournel and Tile classifications for acetabular and pelvic fractures, respectively) and type of surgical treatment. Patients were interviewed about hospitalization length, consultations after discharge, medications, physiotherapy sessions and absenteeism. The study comprised 203 patients, with a mean age of 49.1 ± 15.6 years, who had undergone surgery for an acetabular fracture or pelvic ring injury. The median treatment costs were 29.425 Euros per patient. Sixty percent of the total costs were attributed to health-related work absence. Median costs (in Euros) were 2.767 for hospitalization from trauma to definitive surgery, 4.530 for surgery, 3.018 for hospitalization in the surgical unit, 1.693 for hospitalization in the rehabilitation unit, 1.920 for physiotherapy after discharge and 402 for consultations after discharge. Total costs for treating pelvic ring injuries were higher than for acetabular fractures, mainly due to the significant higher costs of pelvic injuries regarding hospitalization from trauma to definitive surgery (p fractures are associated with both high direct costs and substantial productivity loss.

  1. Cost analysis of paroxetine versus imipramine in major depression.

    Science.gov (United States)

    Bentkover, J D; Feighner, J P

    1995-09-01

    A simulation decision analytical model was used to compare the annual direct medical costs of treating patients with major depression using the selective serotonin reuptake inhibitor (SSRI) paroxetine or the tricyclic antidepressant (TCA) imipramine. Medical treatment patterns were determined from focus groups of general and family practitioners and psychiatrists in Boston, Dallas and Chicago, US. Direct medical costs included the wholesale drug acquisition costs (based on a 6-month course of drug therapy), psychiatrist and/or general practitioner visits, hospital outpatient visits, hospitalisation and electroconvulsive therapy. Acute phase treatment failure rates were derived from an intention-to-treat analysis of a previously published trial of paroxetine, imipramine and placebo in patients with major depression. Maintenance phase relapse rates were obtained from a 12-month trial of paroxetine, supplemented from the medical literature. The relapse rates for the final 6 months of the year were obtained from medical literature and expert opinion. Direct medical costs were estimated from a health insurance claims database. The estimated total direct medical cost per patient was slightly lower using paroxetine ($US2348) than generic imipramine ($US2448) as first-line therapy. This result was sensitive to short term dropout rates but robust to changes in other major parameters, including hospitalisation costs and relapse rates. The financial benefit of paroxetine, despite its 15-fold higher acquisition cost compared with imipramine, is attributable to a higher rate of completion of the initial course of therapy and consequent reduced hospitalisation rates.

  2. Costs and cost-effectiveness analysis of treatment in children with eczema by nurse practitioner vs. dermatologist : results of a randomized, controlled trial and a review of international costs

    NARCIS (Netherlands)

    Schuttelaar, M L A; Vermeulen, K M; Coenraads, P J

    BACKGROUND: In a randomized, controlled trial (RCT) on childhood eczema we reported that substituting nurse practitioners (NPs) for dermatologists resulted in similar outcomes of eczema severity and in the quality of life, and higher patient satisfaction. OBJECTIVES: To determine costs and

  3. Rapamycin inhibits BMP-7-induced osteogenic and lipogenic marker expressions in fetal rat calvarial cells.

    Science.gov (United States)

    Yeh, Lee-Chuan C; Ma, Xiuye; Ford, Jeffery J; Adamo, Martin L; Lee, John C

    2013-08-01

    Bone morphogenetic proteins (BMPs) promote osteoblast differentiation and bone formation in vitro and in vivo. BMPs canonically signal through Smad transcription factors, but BMPs may activate signaling pathways traditionally stimulated by growth factor tyrosine kinase receptors. Of these, the mTOR pathway has received considerable attention because BMPs activate P70S6K, a downstream effector of mTOR, suggesting that BMP-induced osteogenesis is mediated by mTOR activation. However, contradictory effects of the mTOR inhibitor rapamycin (RAPA) on bone formation have been reported. Since bone formation is thought to be inversely related to lipid accumulation and mTOR is also important for lipid synthesis, we postulated that BMP-7 may stimulate lipogenic enzyme expression in a RAPA-sensitive mechanism. To test this hypothesis, we determined the effects of RAPA on BMP-7-stimulated expression of osteogenic and lipogenic markers in cultured fetal rat calvarial cells. Our study showed that BMP-7 promoted the expression of osteogenic and lipogenic markers. The effect of BMP-7 on osteogenic markers was greater in magnitude than on lipogenic markers and was temporally more sustained. RAPA inhibited basal and BMP-7-stimulated osteogenic and lipogenic marker expression and bone nodule mineralization. The acetyl CoA carboxylase inhibitor TOFA stimulated the expression of osteoblast differentiation markers, whereas palmitate suppressed their expression. We speculate that the BMP-7-stimulated adipogenesis is part of the normal anabolic response to BMPs, but that inappropriate activation of the lipid biosynthetic pathway by mTOR could have deleterious effects on bone formation and could explain paradoxical effects of RAPA to promote bone formation. Copyright © 2013 Wiley Periodicals, Inc.

  4. An analysis of the estimated capital cost of a fusion reactor

    International Nuclear Information System (INIS)

    Hollis, A.A.

    1981-06-01

    The cost of building a fusion reactor similar to the Culham Conceptual Tokamak reactor Mark IIB is assessed and compared with other published capital costs of fusion and fission reactors. It is concluded that capital-investment and structure-renewal costs for a typical fusion reactor as presently conceived are likely to be higher than for thermal-fission reactors. (author)

  5. An analysis of the estimated capital cost of a fusion reactor

    International Nuclear Information System (INIS)

    Hollis, A.A.; Evans, L.S.

    1981-01-01

    The cost of building a fusion reactor similar to the Culham Conceptual Tokamak reactor Mark IIB is assessed and compared with other published capital costs of fusion and fission reactors. It is concluded that capital-investment and structure-renewal costs for a typical fusion reactor as presently conceived are likely to be higher than for thermal-fission reactors. (author)

  6. Workforce Investments: State Strategies to Preserve Higher-Cost Career Education Programs in Community and Technical Colleges

    Science.gov (United States)

    Shulock, Nancy; Lewis, Jodi; Tan, Connie

    2013-01-01

    In today's highly-skilled economy, rewarding career pathways are available to those who acquire technical skills by enrolling in certificate and associate degree programs in a community or technical college. Such programs are often more costly to offer than liberal arts and sciences programs that prepare students to transfer to four-year…

  7. Implementation of Forestry Best Management Practices on Biomass and Conventional Harvesting Operations in Virginia

    Directory of Open Access Journals (Sweden)

    Scott M. Barrett

    2016-03-01

    Full Text Available Logging residues are often utilized as a Best Management Practice (BMP for stabilizing bare soil on forest harvesting operations. As utilization of woody biomass increases, concern has developed regarding availability of residues for implementing BMPs. The Virginia Department of Forestry (VDOF inspects all logging operations in Virginia and randomly selects a portion of harvests for more intensive audits. The VDOF BMP audit process intensively evaluates implementation of BMPs in seven categories (84 specific BMPs on 240 sites per year. This research analyzed three years of audit data (2010–2012 to quantify differences in BMP implementation between biomass and conventional harvesting operations. Among 720 audited tracts, 97 were biomass harvests, with 88 occurring in the Piedmont region. Only the streamside management zone (SMZ category had significant implementation percentage differences between biomass (83.1% and conventional harvests (91.4% (p = 0.0007 in the Piedmont. Specific areas where biomass harvesting operations had lower implementation were generally not related to a lack of residues available for implementing BMPs, but rather were from a lack of appropriate SMZs, overharvesting within SMZs, or inadequate construction of roads, skid trails, and stream crossings. Existing BMP recommendations already address these areas and better implementation would have negated these issues.

  8. Multi-protein delivery by nanodiamonds promotes bone formation.

    Science.gov (United States)

    Moore, L; Gatica, M; Kim, H; Osawa, E; Ho, D

    2013-11-01

    Bone morphogenetic proteins (BMPs) are well-studied regulators of cartilage and bone development that have been Food and Drug Administration (FDA)-approved for the promotion of bone formation in certain procedures. BMPs are seeing more use in oral and maxillofacial surgeries because of recent FDA approval of InFUSE(®) for sinus augmentation and localized alveolar ridge augmentation. However, the utility of BMPs in medical and dental applications is limited by the delivery method. Currently, BMPs are delivered to the surgical site by the implantation of bulky collagen sponges. Here we evaluate the potential of detonation nanodiamonds (NDs) as a delivery vehicle for BMP-2 and basic fibroblast growth factor (bFGF). Nanodiamonds are biocompatible, 4- to 5-nm carbon nanoparticles that have previously been used to deliver a wide variety of molecules, including proteins and peptides. We find that both BMP-2 and bFGF are readily loaded onto NDs by physisorption, forming a stable colloidal solution, and are triggered to release in slightly acidic conditions. Simultaneous delivery of BMP-2 and bFGF by ND induces differentiation and proliferation in osteoblast progenitor cells. Overall, we find that NDs provide an effective injectable alternative for the delivery of BMP-2 and bFGF to promote bone formation.

  9. 12 CFR 219.3 - Cost reimbursement.

    Science.gov (United States)

    2010-01-01

    ... that the financial institution use programming or other higher level technical services of a computer... (private sector) set out in the Employment Cost Trends section of the National Compensation Survey (http... PROVIDING FINANCIAL RECORDS; RECORDKEEPING REQUIREMENTS FOR CERTAIN FINANCIAL RECORDS (REGULATION S...

  10. Physician awareness of drug cost: a systematic review.

    Science.gov (United States)

    Allan, G Michael; Lexchin, Joel; Wiebe, Natasha

    2007-09-01

    Pharmaceutical costs are the fastest-growing health-care expense in most developed countries. Higher drug costs have been shown to negatively impact patient outcomes. Studies suggest that doctors have a poor understanding of pharmaceutical costs, but the data are variable and there is no consistent pattern in awareness. We designed this systematic review to investigate doctors' knowledge of the relative and absolute costs of medications and to determine the factors that influence awareness. Our search strategy included The Cochrane Library, EconoLit, EMBASE, and MEDLINE as well as reference lists and contact with authors who had published two or more articles on the topic or who had published within 10 y of the commencement of our review. Studies were included if: either doctors, trainees (interns or residents), or medical students were surveyed; there were more than ten survey respondents; cost of pharmaceuticals was estimated; results were expressed quantitatively; there was a clear description of how authors defined "accurate estimates"; and there was a description of how the true cost was determined. Two authors reviewed each article for eligibility and extracted data independently. Cost accuracy outcomes were summarized, but data were not combined in meta-analysis because of extensive heterogeneity. Qualitative data related to physicians and drug costs were also extracted. The final analysis included 24 articles. Cost accuracy was low; 31% of estimates were within 20% or 25% of the true cost, and fewer than 50% were accurate by any definition of cost accuracy. Methodological weaknesses were common, and studies of low methodological quality showed better cost awareness. The most important factor influencing the pattern and accuracy of estimation was the true cost of therapy. High-cost drugs were estimated more accurately than inexpensive ones (74% versus 31%, Chi-square p price of expensive drugs and overestimate the price of inexpensive ones, demonstrate a

  11. Cost-effective strategies for rural community outreach, Hawaii, 2010-2011.

    Science.gov (United States)

    Pellegrin, Karen L; Barbato, Anna; Holuby, R Scott; Ciarleglio, Anita E; Taniguchi, Ronald

    2014-12-11

    Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members.

  12. Estimation of marginal costs at existing waste treatment facilities

    DEFF Research Database (Denmark)

    Martinez Sanchez, Veronica; Hulgaard, Tore; Hindsgaul, Claus

    2016-01-01

    , marginal costs were not (provided a response was initiated at the WtE to keep constant the utilized thermal capacity). Failing to systematically address and include costs in existing waste facilities in decision-making may unintendedly lead to higher overall costs at societal level. To avoid misleading...... a constant thermal load, (ii) Refused-Derived-Fuel (RDF) was included to maintain a constant thermal load, or (iii) no reaction occurred resulting in a reduced waste throughput without full utilization of the facility capacity. Results demonstrated that marginal costs of diversion from WtE were up to eleven...

  13. Cost estimates for flat plate and concentrator collector arrays

    Science.gov (United States)

    Shimada, K.

    1982-01-01

    The current module and installation costs for the U.S. National Photovoltaic Program's grid-connected systems are significantly higher than required for economic viability of this alternative. Attention is accordingly given to the prospects for installed module cost reductions in flat plate, linear focus Fresnel concentrator, and point focus Fresnel concentrator candidate systems. Cost projections indicate that all three systems would meet near-term and midterm goals, provided that module costs of $2.80/W(p) and $0.70/W(p), respectively, are met. The point focus Fresnel system emerges as the most viable for the near term.

  14. A Comparison of Response Rate, Response Time, and Costs of Mail and Electronic Surveys.

    Science.gov (United States)

    Shannon, David M.; Bradshaw, Carol C.

    2002-01-01

    Compared response rates, response time, and costs of mail and electronic surveys using a sample of 377 college faculty members. Mail surveys yielded a higher response rate and a lower rate of undeliverable surveys, but response time was longer and costs were higher than for electronic surveys. (SLD)

  15. The Decision-Making Process for Families Investing in Higher Education: A Family Systems Perspective

    Science.gov (United States)

    McHugh, Erin M.

    2017-01-01

    When families consider investing in their children's education they must weigh the perceived costs against the potential benefits, which becomes increasingly difficult as the cost of higher education continues to rise. Using a family systems approach, this phenomenological study explored the central research question, "How do families…

  16. Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition.

    Science.gov (United States)

    Morales, Eva; Cots, Francesc; Sala, Maria; Comas, Mercè; Belvis, Francesc; Riu, Marta; Salvadó, Margarita; Grau, Santiago; Horcajada, Juan P; Montero, Maria Milagro; Castells, Xavier

    2012-05-23

    We aimed to assess the hospital economic costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. A retrospective study of all hospital admissions between January 1, 2005, and December 31, 2006 was carried out in a 420-bed, urban, tertiary-care teaching hospital in Barcelona (Spain). All patients with a first positive clinical culture for P. aeruginosa more than 48 h after admission were included. Patient and hospitalization characteristics were collected from hospital and microbiology laboratory computerized records. According to antibiotic susceptibility, isolates were classified as non-resistant, resistant and multi-drug resistant. Cost estimation was based on a full-costing cost accounting system and on the criteria of clinical Activity-Based Costing methods. Multivariate analyses were performed using generalized linear models of log-transformed costs. Cost estimations were available for 402 nosocomial incident P. aeruginosa positive cultures. Their distribution by antibiotic susceptibility pattern was 37.1% non-resistant, 29.6% resistant and 33.3% multi-drug resistant. The total mean economic cost per admission of patients with multi-drug resistant P. aeruginosa strains was higher than that for non-resistant strains (15,265 vs. 4,933 Euros). In multivariate analysis, resistant and multi-drug resistant strains were independently predictive of an increased hospital total cost in compared with non-resistant strains (the incremental increase in total hospital cost was more than 1.37-fold and 1.77-fold that for non-resistant strains, respectively). P. aeruginosa multi-drug resistance independently predicted higher hospital costs with a more than 70% increase per admission compared with non-resistant strains. Prevention of the nosocomial emergence and spread of antimicrobial resistant microorganisms is essential to limit the strong economic impact.

  17. The cost of multiple sclerosis drugs in the US and the pharmaceutical industry

    Science.gov (United States)

    Bourdette, Dennis N.; Ahmed, Sharia M.; Whitham, Ruth H.

    2015-01-01

    Objective: To examine the pricing trajectories in the United States of disease-modifying therapies (DMT) for multiple sclerosis (MS) over the last 20 years and assess the influences on rising prices. Methods: We estimated the trend in annual drug costs for 9 DMTs using published drug pricing data from 1993 to 2013. We compared changes in DMT costs to general and prescription drug inflation during the same period. We also compared the cost trajectories for first-generation MS DMTs interferon (IFN)–β-1b, IFN-β-1a IM, and glatiramer acetate with contemporaneously approved biologic tumor necrosis factor (TNF) inhibitors. Results: First-generation DMTs, originally costing $8,000 to $11,000, now cost about $60,000 per year. Costs for these agents have increased annually at rates 5 to 7 times higher than prescription drug inflation. Newer DMTs commonly entered the market with a cost 25%–60% higher than existing DMTs. Significant increases in the cost trajectory of the first-generation DMTs occurred following the Food and Drug Administration approvals of IFN-β-1a SC (2002) and natalizumab (reintroduced 2006) and remained high following introduction of fingolimod (2010). Similar changes did not occur with TNF inhibitor biologics during these time intervals. DMT costs in the United States currently are 2 to 3 times higher than in other comparable countries. Conclusions: MS DMT costs have accelerated at rates well beyond inflation and substantially above rates observed for drugs in a similar biologic class. There is an urgent need for clinicians, payers, and manufacturers in the United States to confront the soaring costs of DMTs. PMID:25911108

  18. Direct health care costs associated with obesity in Chinese population in 2011.

    Science.gov (United States)

    Shi, Jingcheng; Wang, Yao; Cheng, Wenwei; Shao, Hui; Shi, Lizheng

    2017-03-01

    Overweight and obesity are established major risk factors for type 2 diabetes, and major public health concerns in China. This study aims to assess the economic burden associated with overweight and obesity in the Chinese population ages 45 and older. The Chinese Health and Retirement Longitudinal Study (CHARLS) in 2011 included 13,323 respondents of ages 45 and older living in 450 rural and urban communities across China. Demographic information, height, weight, direct health care costs for outpatient visits, hospitalization, and medications for self-care were extracted from the CHARLS database. Health Care costs were calculated in 2011 Chinese currency. The body mass index (BMI) was used to categorize underweight, normal weight, overweight, and obese populations. Descriptive analyses and a two-part regression model were performed to investigate the association of BMI with health care costs. To account for non-normality of the cost data, we applied a non-parametric bootstrap approach using the percentile method to estimate the 95% confidence intervals (95% CIs). Overweight and obese groups had significantly higher total direct health care costs (RMB 2246.4, RMB 2050.7, respectively) as compared with the normal-weight group (RMB 1886.0). When controlling for demographic characteristics, overweight and obese adults were 15.0% and 35.9% more likely to incur total health care costs, and obese individuals had 14.2% higher total health care costs compared with the normal-weight group. Compared with the normal-weight counterparts, the annual total direct health care costs were significantly higher among obese adults in China. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Reward Pays the Cost of Noise Reduction in Motor and Cognitive Control.

    Science.gov (United States)

    Manohar, Sanjay G; Chong, Trevor T-J; Apps, Matthew A J; Batla, Amit; Stamelou, Maria; Jarman, Paul R; Bhatia, Kailash P; Husain, Masud

    2015-06-29

    Speed-accuracy trade-off is an intensively studied law governing almost all behavioral tasks across species. Here we show that motivation by reward breaks this law, by simultaneously invigorating movement and improving response precision. We devised a model to explain this paradoxical effect of reward by considering a new factor: the cost of control. Exerting control to improve response precision might itself come at a cost--a cost to attenuate a proportion of intrinsic neural noise. Applying a noise-reduction cost to optimal motor control predicted that reward can increase both velocity and accuracy. Similarly, application to decision-making predicted that reward reduces reaction times and errors in cognitive control. We used a novel saccadic distraction task to quantify the speed and accuracy of both movements and decisions under varying reward. Both faster speeds and smaller errors were observed with higher incentives, with the results best fitted by a model including a precision cost. Recent theories consider dopamine to be a key neuromodulator in mediating motivational effects of reward. We therefore examined how Parkinson's disease (PD), a condition associated with dopamine depletion, alters the effects of reward. Individuals with PD showed reduced reward sensitivity in their speed and accuracy, consistent in our model with higher noise-control costs. Including a cost of control over noise explains how reward may allow apparent performance limits to be surpassed. On this view, the pattern of reduced reward sensitivity in PD patients can specifically be accounted for by a higher cost for controlling noise. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Hospital staffing and hospital costs.

    Science.gov (United States)

    Andrew, R R

    1976-08-07

    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  1. Accounting for enforcement costs in the spatial allocation of marine zones.

    Science.gov (United States)

    Davis, Katrina; Kragt, Marit; Gelcich, Stefan; Schilizzi, Steven; Pannell, David

    2015-02-01

    Marine fish stocks are in many cases extracted above sustainable levels, but they may be protected through restricted-use zoning systems. The effectiveness of these systems typically depends on support from coastal fishing communities. High management costs including those of enforcement may, however, deter fishers from supporting marine management. We incorporated enforcement costs into a spatial optimization model that identified how conservation targets can be met while maximizing fishers' revenue. Our model identified the optimal allocation of the study area among different zones: no-take, territorial user rights for fisheries (TURFs), or open access. The analysis demonstrated that enforcing no-take and TURF zones incurs a cost, but results in higher species abundance by preventing poaching and overfishing. We analyzed how different enforcement scenarios affected fishers' revenue. Fisher revenue was approximately 50% higher when territorial user rights were enforced than when they were not. The model preferentially allocated area to the enforced-TURF zone over other zones, demonstrating that the financial benefits of enforcement (derived from higher species abundance) exceeded the costs. These findings were robust to increases in enforcement costs but sensitive to changes in species' market price. We also found that revenue under the existing zoning regime in the study area was 13-30% lower than under an optimal solution. Our results highlight the importance of accounting for both the benefits and costs of enforcement in marine conservation, particularly when incurred by fishers. © 2014 Society for Conservation Biology.

  2. Greater accordance with the Dietary Approaches to Stop Hypertension dietary pattern is associated with lower diet-related greenhouse gas production but higher dietary costs in the United Kingdom12

    Science.gov (United States)

    Monsivais, Pablo; Scarborough, Peter; Lloyd, Tina; Mizdrak, Anja; Luben, Robert; Mulligan, Angela A; Wareham, Nicholas J; Woodcock, James

    2015-01-01

    Background: The Dietary Approaches to Stop Hypertension (DASH) diet is a proven way to prevent and control hypertension and other chronic disease. Because the DASH diet emphasizes plant-based foods, including vegetables and grains, adhering to this diet might also bring about environmental benefits, including lower associated production of greenhouse gases (GHGs). Objective: The objective was to examine the interrelation between dietary accordance with the DASH diet and associated GHGs. A secondary aim was to examine the retail cost of diets by level of DASH accordance. Design: In this cross-sectional study of adults aged 39–79 y from the European Prospective Investigation into Cancer and Nutrition–Norfolk, United Kingdom cohort (n = 24,293), dietary intakes estimated from food-frequency questionnaires were analyzed for their accordance with the 8 DASH food and nutrient-based targets. Associations between DASH accordance, GHGs, and dietary costs were evaluated in regression analyses. Dietary GHGs were estimated with United Kingdom-specific data on carbon dioxide equivalents associated with commodities and foods. Dietary costs were estimated by using national food prices from a United Kingdom–based supermarket comparison website. Results: Greater accordance with the DASH dietary targets was associated with lower GHGs. Diets in the highest quintile of accordance had a GHG impact of 5.60 compared with 6.71 kg carbon dioxide equivalents/d for least-accordant diets (P dietary costs, with the mean cost of diets in the top quintile of DASH scores 18% higher than that of diets in the lowest quintile (P < 0.0001). Conclusions: Promoting wider uptake of the DASH diet in the United Kingdom may improve population health and reduce diet-related GHGs. However, to make the DASH diet more accessible, food affordability, particularly for lower income groups, will have to be addressed. PMID:25926505

  3. Evidence for Distinguishable Treatment Costs among Paranoid Schizophrenia and Schizoaffective Disorder.

    Science.gov (United States)

    Hirjak, Dusan; Hochlehnert, Achim; Thomann, Philipp Arthur; Kubera, Katharina Maria; Schnell, Knut

    2016-01-01

    Schizophrenia spectrum disorders result in enormous individual suffering and financial burden on patients and on society. In Germany, there are about 1,000,000 individuals suffering from schizophrenia (SZ) or schizoaffective disorder (SAD), a combination of psychotic and affective symptoms. Given the heterogeneous nature of these syndromes, one may assume that there is a difference in treatment costs among patients with paranoid SZ and SAD. However, the current the national system of cost accounting in psychiatry and psychosomatics in Germany assesses all schizophrenia spectrum disorders within one category. The study comprised a retrospective audit of data from 118 patients diagnosed with paranoid SZ (F20.0) and 71 patients with SAD (F25). We used the mean total costs as well as partial cost, i.e., mean costs for medication products, mean personal costs and mean infrastructure costs from each patient for the statistical analysis. We tested for differences in the four variables between SZ and SAD patients using ANCOVA and confirmed the results with bootstrapping. SAD patients had a longer duration of stay than patients with SZ (p = .02). Mean total costs were significantly higher for SAD patients (p = .023). Further, we found a significant difference in mean personnel costs (p = .02) between patients with SZ and SAD. However, we found no significant differences in mean pharmaceutical costs (p = .12) but a marginal difference of mean infrastructure costs (p = .05) between SZ and SAD. We found neither a common decrease of costs over time nor a differential decrease in SZ and SAD. We found evidence for a difference of case related costs of inpatient treatments for paranoid SZ and SAD. The differences in mean total costs seem to be primarily related to the mean personnel costs in patients with paranoid SZ and SAD rather than mean pharmaceutical costs, possibly due to higher personnel effort and infrastructure.

  4. Evidence for Distinguishable Treatment Costs among Paranoid Schizophrenia and Schizoaffective Disorder.

    Directory of Open Access Journals (Sweden)

    Dusan Hirjak

    Full Text Available Schizophrenia spectrum disorders result in enormous individual suffering and financial burden on patients and on society. In Germany, there are about 1,000,000 individuals suffering from schizophrenia (SZ or schizoaffective disorder (SAD, a combination of psychotic and affective symptoms. Given the heterogeneous nature of these syndromes, one may assume that there is a difference in treatment costs among patients with paranoid SZ and SAD. However, the current the national system of cost accounting in psychiatry and psychosomatics in Germany assesses all schizophrenia spectrum disorders within one category.The study comprised a retrospective audit of data from 118 patients diagnosed with paranoid SZ (F20.0 and 71 patients with SAD (F25. We used the mean total costs as well as partial cost, i.e., mean costs for medication products, mean personal costs and mean infrastructure costs from each patient for the statistical analysis. We tested for differences in the four variables between SZ and SAD patients using ANCOVA and confirmed the results with bootstrapping.SAD patients had a longer duration of stay than patients with SZ (p = .02. Mean total costs were significantly higher for SAD patients (p = .023. Further, we found a significant difference in mean personnel costs (p = .02 between patients with SZ and SAD. However, we found no significant differences in mean pharmaceutical costs (p = .12 but a marginal difference of mean infrastructure costs (p = .05 between SZ and SAD. We found neither a common decrease of costs over time nor a differential decrease in SZ and SAD.We found evidence for a difference of case related costs of inpatient treatments for paranoid SZ and SAD. The differences in mean total costs seem to be primarily related to the mean personnel costs in patients with paranoid SZ and SAD rather than mean pharmaceutical costs, possibly due to higher personnel effort and infrastructure.

  5. Cost analysis of surgical treatment for pelvic organ prolapse by laparoscopic sacrocolpopexy or transvaginal mesh.

    Science.gov (United States)

    Carracedo, D; López-Fando, L; Sánchez, M D; Jiménez, M Á; Gómez, J M; Laso, I; Rodríguez, M Á; Burgos, F J

    2017-03-01

    The objective of this study is to compare direct costs of repairing pelvic organ prolapse by laparoscopic sacrocolpopexy (LS) against vaginal mesh (VM). Our hypothesis is the correction of pelvic organ prolapse by LS has a similar cost per procedure compared to VM. We made a retrospective comparative analysis of medium cost per procedure of first 69 consecutive LS versus first 69 consecutive VM surgeries. We calculate direct cost for each procedure: structural outlays, personal, operating room occupation, hospital stay, perishable or inventory material and prosthetic material. Medium cost per procedure were calculated for each group, with a 95% confidence interval. LS group has a higher cost related to a longer length of surgery, higher operating room occupation and anesthesia; VM group has a higher cost due to longer hospital stay and more expensive prosthetic material. Globally, LS has a lower medium cost per procedure in comparison to VM (5,985.7 €±1,550.8 € vs. 6,534.3 €±1,015.5 €), although it did not achieve statistical signification. In our midst, pelvic organ prolapse surgical correction by LS has at least similar cost per procedure compared to VM. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. The Cost of Joint Replacement: Comparing Two Approaches to Evaluating Costs of Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Palsis, John A; Brehmer, Thomas S; Pellegrini, Vincent D; Drew, Jacob M; Sachs, Barton L

    2018-02-21

    In an era of mandatory bundled payments for total joint replacement, accurate analysis of the cost of procedures is essential for orthopaedic surgeons and their institutions to maintain viable practices. The purpose of this study was to compare traditional accounting and time-driven activity-based costing (TDABC) methods for estimating the total costs of total hip and knee arthroplasty care cycles. We calculated the overall costs of elective primary total hip and total knee replacement care cycles at our academic medical center using traditional and TDABC accounting methods. We compared the methods with respect to the overall costs of hip and knee replacement and the costs for each major cost category. The traditional accounting method resulted in higher cost estimates. The total cost per hip replacement was $22,076 (2014 USD) using traditional accounting and was $12,957 using TDABC. The total cost per knee replacement was $29,488 using traditional accounting and was $16,981 using TDABC. With respect to cost categories, estimates using traditional accounting were greater for hip and knee replacement, respectively, by $3,432 and $5,486 for personnel, by $3,398 and $3,664 for space and equipment, and by $2,289 and $3,357 for indirect costs. Implants and consumables were derived from the actual hospital purchase price; accordingly, both methods produced equivalent results. Substantial cost differences exist between accounting methods. The focus of TDABC only on resources used directly by the patient contrasts with the allocation of all operating costs, including all indirect costs and unused capacity, with traditional accounting. We expect that the true costs of hip and knee replacement care cycles are likely somewhere between estimates derived from traditional accounting methods and TDABC. TDABC offers patient-level granular cost information that better serves in the redesign of care pathways and may lead to more strategic resource-allocation decisions to optimize

  7. Lean VOC-Air Mixtures Catalytic Treatment: Cost-Benefit Analysis of Competing Technologies

    Directory of Open Access Journals (Sweden)

    Gabriele Baldissone

    2017-06-01

    Full Text Available Various processing routes are available for the treatment of lean VOC-air mixtures, and a cost-benefit analysis is the tool we propose to identify the most suitable technology. Two systems have been compared in this paper, namely a “traditional” plant, with a catalytic fixed-bed reactor with a heat exchanger for heat recovery purposes, and a “non-traditional” plant, with a catalytic reverse-flow reactor, where regenerative heat recovery may be achieved thanks to the periodical reversal of the flow direction. To be useful for decisions-making, the cost-benefit analysis must be coupled to the reliability, or availability, analysis of the plant. Integrated Dynamic Decision Analysis is used for this purpose as it allows obtaining the full set of possible sequences of events that could result in plant unavailability, and, for each of them, the probability of occurrence is calculated. Benefits are thus expressed in terms of out-of-services times, that have to be minimized, while the costs are expressed in terms of extra-cost for maintenance activities and recovery actions. These variable costs must be considered together with the capital (fixed cost required for building the plant. Results evidenced the pros and cons of the two plants. The “traditional” plant ensures a higher continuity of services, but also higher operational costs. The reverse-flow reactor-based plant exhibits lower operational costs, but a higher number of protection levels are needed to obtain a similar level of out-of-service. The quantification of risks and benefits allows the stakeholders to deal with a complete picture of the behavior of the plants, fostering a more effective decision-making process. With reference to the case under study and the relevant operational conditions, the regenerative system was demonstrated to be more suitable to treat lean mixtures: in terms of time losses following potential failures the two technologies are comparable (Fixed bed

  8. An equivalent marginal cost-pricing model for the district heating market

    International Nuclear Information System (INIS)

    Zhang, Junli; Ge, Bin; Xu, Hongsheng

    2013-01-01

    District heating pricing is a core element in reforming the heating market. Existing district heating pricing methods, such as the cost-plus pricing method and the conventional marginal-cost pricing method, cannot simultaneously provide both high efficiency and sufficient investment cost return. To solve this problem, the paper presents a new pricing model, namely Equivalent Marginal Cost Pricing (EMCP) model, which is based on the EVE pricing theory and the unique characteristics of heat products and district heating. The EMCP model uses exergy as the measurement of heating product value and places products from different district heating regions into the same competition platform. In the proposed model, the return on investment cost is closely related to the quoted cost, and within the limitations of the Heating Capacity Cost Reference and the maximum compensated shadow capacity cost, both lower and higher price speculations of heat producers are restricted. Simulation results show that the model can guide heat producers to bid according to their production costs and to provide reasonable returns on investment, which contributes to stimulate the role of price leverage and to promote the optimal allocation of heat resources. - Highlights: • Presents a new district heating pricing model. • Provides both high market efficiency and sufficient investment cost return. • Provides a competition mechanism for various products from different DH regions. • Both of lower and higher price speculations are restricted in the new model

  9. Do higher-priced generic medicines enjoy a competitive advantage under reference pricing?

    Science.gov (United States)

    Puig-Junoy, Jaume

    2012-11-01

    In many countries with generic reference pricing, generic producers and distributors compete by means of undisclosed discounts offered to pharmacies in order to reduce acquisition costs and to induce them to dispense their generic to patients in preference over others. The objective of this article is to test the hypothesis that under prevailing reference pricing systems for generic medicines, those medicines sold at a higher consumer price may enjoy a competitive advantage. Real transaction prices for 179 generic medicines acquired by pharmacies in Spain have been used to calculate the discount rate on acquisition versus reimbursed costs to pharmacies. Two empirical hypotheses are tested: the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical presentations for which there are more generic competitors; and, the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical forms for which the consumer price has declined less in relation to the consumer price of the brand drug before generic entry (higher-priced generic medicines). An average discount rate of 39.3% on acquisition versus reimbursed costs to pharmacies has been observed. The magnitude of the discount positively depends on the number of competitors in the market. The higher the ratio of the consumer price of the generic to that of the brand drug prior to generic entry (i.e. the smaller the price reduction of the generic in relation to the brand drug), the larger the discount rate. Under reference pricing there is intense price competition among generic firms in the form of unusually high discounts to pharmacies on official ex-factory prices reimbursed to pharmacies. However, this effect is highly distorting because it favours those medicines with a higher relative price in relation to the brand price before generic entry.

  10. Intensive care unit drug costs in the context of total hospital drug expenditures with suggestions for targeted cost containment efforts.

    Science.gov (United States)

    Altawalbeh, Shoroq M; Saul, Melissa I; Seybert, Amy L; Thorpe, Joshua M; Kane-Gill, Sandra L

    2018-04-01

    To assess costs of intensive care unit (ICU) related pharmacotherapy relative to hospital drug expenditures, and to identify potential targets for cost-effectiveness investigations. We offer the unique advantage of comparing ICU drug costs with previously published data a decade earlier to describe changes over time. Financial transactions for all ICU patients during fiscal years (FY) 2009-2012 were retrieved from the hospital's data repository. ICU drug costs were evaluated for each FY. ICU departments' charges were also retrieved and calculated as percentages of total ICU charges. Albumin, prismasate (dialysate), voriconazole, factor VII and alteplase denoted the highest percentages of ICU drug costs. ICU drug costs contributed to an average of 31% (SD 1.0%) of the hospital's total drug costs. ICU drug costs per patient day increased by 5.8% yearly versus 7.8% yearly for non-ICU drugs. This rate was higher for ICU drugs costs at 12% a decade previous. Pharmacy charges contributed to 17.7% of the total ICU charges. Growth rates of costs per year have declined but still drug expenditures in the ICU are consistently a significant driver in this resource intensive environment with a high impact on hospital drug expenditures. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Benefit/cost comparisons for utility SMES applications

    International Nuclear Information System (INIS)

    De Steese, J.G.; Dagle, J.E.

    1991-01-01

    This paper summarizes eight cases studies that account for the benefits and costs of superconducting magnetic energy storage (SMES) in system-specific utility applications. Four of these scenarios are hypothetical SMES application in the Pacific Northwest, where relatively low energy costs impose a stringent test on the viability of the concept. The other four scenarios address SMES applications on high-voltage, direct-current (HVDC) transmission lines. While estimated SMES benefits are based on a previously reported methodology, this paper presents results of an improved cost-estimating approach that includes an assumed reduction in the cost of the power conditioning system (PCS) from approximately $160/kW to $80/kW. The revised approach results in all the SMES scenarios showing higher benefit/cost ratios that those reported earlier. However, in all but two cases, the value of any single benefit is still less than the unit's levelized cost. This suggests, as a general principle, that the total value of multiple benefits should always be considered if SMES is to appear cost effective in may utility applications. These results should offer utilities further encouragement to conduct more detailed analyses of SMES benefits in scenarios that apply to individual systems

  12. Indirect costs of teaching in Canadian hospitals.

    Science.gov (United States)

    MacKenzie, T A; Willan, A R; Cox, M A; Green, A

    1991-01-01

    We sought to determine whether there are indirect costs of teaching in Canadian hospitals. To examine cost differences between teaching and nonteaching hospitals we estimated two cost functions: cost per case and cost per patient-day (dependent variables). The independent variables were number of beds, occupancy rate, teaching ratio (number of residents and interns per 100 beds), province, urbanicity (the population density of the county in which the hospital was situated) and wage index. Within each hospital we categorized a random sample of patient discharges according to case mix and severity of illness using age and standard diagnosis and procedure codes. Teaching ratio and case severity were each highly correlated positively with the dependent variables. The other variables that led to higher costs in teaching hospitals were wage rates and number of beds. Our regression model could serve as the basis of a reimbursement system, adjusted for severity and teaching status, particularly in provinces moving toward introducing case-weighting mechanisms into their payment model. Even if teaching hospitals were paid more than nonteaching hospitals because of the difference in the severity of illness there should be an additional allowance to cover the indirect costs of teaching. PMID:1898870

  13. Benefit/cost comparison for utility SMES applications

    Science.gov (United States)

    Desteese, J. G.; Dagle, J. E.

    1991-08-01

    This paper summarizes eight case studies that account for the benefits and costs of superconducting magnetic energy storage (SMES) in system-specific utility applications. Four of these scenarios are hypothetical SMES applications in the Pacific Northwest, where relatively low energy costs impose a stringent test on the viability of the concept. The other four scenarios address SMES applications on high-voltage, direct-current (HVDC) transmission lines. While estimated SMES benefits are based on a previously reported methodology, this paper presents results of an improved cost-estimating approach that includes an assumed reduction in the cost of the power conditioning system (PCS) from approximately $160/kW to $80/kW. The revised approach results in all the SMES scenarios showing higher benefit/cost ratios than those reported earlier. However, in all but two cases, the value of any single benefit is still less than the unit's levelized cost. This suggests, as a general principle, that the total value of multiple benefits should always be considered if SMES is to appear cost effective in many utility applications. These results should offer utilities further encouragement to conduct more detailed analyses of SMES benefits in scenarios that apply to individual systems.

  14. Yükseköğretimin Finansmanı ve Türkiye İçin Yükseköğretim Finansman Modeli Önerisi(Financing Higher Education: Proposal For Higher Education Model In Turkey

    Directory of Open Access Journals (Sweden)

    Haşim AKÇA

    2012-01-01

    Full Text Available Higher education is a mixed commodity. Considering its attribute, it is a service benefiting its users directly and society indirectly. Therefore it is necessary that higher education be catered continuously. In this context, higher education institutions should prompt the dynamics of societal development and lead the society toward better future. One of fundamental task for universities is to provide positive externalities for the entire society. However, universities often face important financial difficulties to extent the externalities they provide. In recent years alternative resources also are employed in financing higher education. For instance it is universally accepted application that some of the costs of higher education are accrued to the direct beneficiaries or the students. In some countries however higher education is solely funded by public resources because higher education in these countries is considered as public good. However in the recent years, a widespread belief suggests that public resources are not fit for efficient use, therefore alternative means of higher education finance are being explored. One such means appears to be an income-contingent system or student borrowing system. This method eases the burden of public finance and allows for students to assume a partial cost of higher education.

  15. Realistic costs of carbon capture

    Energy Technology Data Exchange (ETDEWEB)

    Al Juaied, Mohammed (Harvard Univ., Cambridge, MA (US). Belfer Center for Science and International Affiaris); Whitmore, Adam (Hydrogen Energy International Ltd., Weybridge (GB))

    2009-07-01

    There is a growing interest in carbon capture and storage (CCS) as a means of reducing carbon dioxide (CO2) emissions. However there are substantial uncertainties about the costs of CCS. Costs for pre-combustion capture with compression (i.e. excluding costs of transport and storage and any revenue from EOR associated with storage) are examined in this discussion paper for First-of-a-Kind (FOAK) plant and for more mature technologies, or Nth-of-a-Kind plant (NOAK). For FOAK plant using solid fuels the levelised cost of electricity on a 2008 basis is approximately 10 cents/kWh higher with capture than for conventional plants (with a range of 8-12 cents/kWh). Costs of abatement are found typically to be approximately US$150/tCO2 avoided (with a range of US$120-180/tCO2 avoided). For NOAK plants the additional cost of electricity with capture is approximately 2-5 cents/kWh, with costs of the range of US$35-70/tCO2 avoided. Costs of abatement with carbon capture for other fuels and technologies are also estimated for NOAK plants. The costs of abatement are calculated with reference to conventional SCPC plant for both emissions and costs of electricity. Estimates for both FOAK and NOAK are mainly based on cost data from 2008, which was at the end of a period of sustained escalation in the costs of power generation plant and other large capital projects. There are now indications of costs falling from these levels. This may reduce the costs of abatement and costs presented here may be 'peak of the market' estimates. If general cost levels return, for example, to those prevailing in 2005 to 2006 (by which time significant cost escalation had already occurred from previous levels), then costs of capture and compression for FOAK plants are expected to be US$110/tCO2 avoided (with a range of US$90-135/tCO2 avoided). For NOAK plants costs are expected to be US$25-50/tCO2. Based on these considerations a likely representative range of costs of abatement from CCS

  16. The cost of nurse-sensitive adverse events.

    Science.gov (United States)

    Pappas, Sharon Holcombe

    2008-05-01

    The aim of this study was to describe the methodology for nursing leaders to determine the cost of adverse events and effective levels of nurse staffing. The growing transparency of quality and cost outcomes motivates healthcare leaders to optimize the effectiveness of nurse staffing. Most hospitals have robust cost accounting systems that provide actual patient-level direct costs. These systems allow an analysis of the cost consumed by patients during a hospital stay. By knowing the cost of complications, leaders have the ability to justify the cost of improved staffing when quality evidence shows that higher nurse staffing improves quality. An analysis was performed on financial and clinical data from hospital databases of 3,200 inpatients. The purpose was to establish a methodology to determine actual cost per case. Three diagnosis-related groups were the focus of the analysis. Five adverse events were analyzed along with the costs. A regression analysis reported that the actual direct cost of an adverse event was dollars 1,029 per case in the congestive heart failure cases and dollars 903 in the surgical cases. There was a significant increase in the cost per case in medical patients with urinary tract infection and pressure ulcers and in surgical patients with urinary tract infection and pneumonia. The odds of pneumonia occurring in surgical patients decreased with additional registered nurse hours per patient day. Hospital cost accounting systems are useful in determining the cost of adverse events and can aid in decision making about nurse staffing. Adverse events add costs to patient care and should be measured at the unit level to adjust staffing to reduce adverse events and avoid costs.

  17. Pros, cons of techniques used to calculate oil, gas finding costs

    International Nuclear Information System (INIS)

    Gaddis, D.; Brock, H.; Boynton, C.

    1992-01-01

    A major problem facing the U.S. petroleum industry is the higher average finding costs that now exist within the U.S. compared with the average finding costs outside the U.S. It has been argued that federal lands and offshore areas need to be open for drilling in order to reduce average finding costs in the U.S. This article analyzes the strengths and weaknesses of conventional techniques for determining finding costs. Our goal is a finding costs measure that is a reliable indicator of future profitability

  18. All-Cause and Acute Pancreatitis Health Care Costs in Patients With Severe Hypertriglyceridemia.

    Science.gov (United States)

    Rashid, Nazia; Sharma, Puza P; Scott, Ronald D; Lin, Kathy J; Toth, Peter P

    2017-01-01

    The aim of this study was to assess health care utilization and costs related to acute pancreatitis (AP) in patients with severe hypertriglyceridemia (sHTG) levels. Patients with sHTG levels 1000 mg/dL or higher were identified from January 1, 2007, to June 30, 2013. The first identified incident triglyceride level was labeled as index date. All-cause, AP-related health care visits, and mean total all-cause costs in patients with and without AP were compared during 12 months postindex. A generalized linear model regression was used to compare costs while controlling for patient characteristics and comorbidities. Five thousand five hundred fifty sHTG patients were identified, and 5.4% of these patients developed AP during postindex. Patients with AP had significantly (P < 0.05) more all-cause outpatient visits, hospitalizations, longer length of stays during the hospital visits, and emergency department visits versus patients without AP. Mean (SD) unadjusted all-cause health care costs in the 12 months postindex were $25,343 ($33,139) for patients with AP compared with $15,195 ($24,040) for patients with no AP. The regression showed annual all-cause costs were 49.9% higher (P < 0.01) for patients with AP versus without AP. Patients who developed AP were associated with higher costs; managing patients with sHTG at risk of developing AP may help reduce unnecessary costs.

  19. Additive versus multiplicative trade costs and the gains from trade

    DEFF Research Database (Denmark)

    Sørensen, Allan

    This paper addresses welfare effects from trade liberalization in a heterogeneous-fi…rms trade model including the empirically important per-unit (i.e. additive) trade costs in addition to the conventional iceberg (i.e. multiplicative) and fi…xed trade costs. The novel contribution of the paper...... is the result that the welfare gain for a given increase in trade openness is higher for reductions in per-unit (additive) trade costs than for reductions in iceberg (multiplicative) trade costs. The ranking derives from differences in intra-industry reallocations and in particular from dissimilar impacts...

  20. Enabling Process Improvement and Control in Higher Education Management

    Science.gov (United States)

    Bell, Gary; Warwick, Jon; Kennedy, Mike

    2009-01-01

    The emergence of "managerialism" in the governance and direction of UK higher education (HE) institutions has been led by government demands for greater accountability in the quality and cost of universities. There is emerging anecdotal evidence indicating that the estimation performance of HE spreadsheets and regression models are poor.…

  1. Production cost of biomasses from eucalyptus and elefant grass for energy

    Directory of Open Access Journals (Sweden)

    Laurent Marie Roger Quéno

    2011-09-01

    Full Text Available This work established the unit energy cost generated from biomass of eucalyptus (Eucalyptus sp. and elephant grass (Pennisetum sp. and applied a sensitivity analysis to verify the influences of factors such as the silviculture of eucalyptus, production volume of each species, the cost of land and the interest rate. It was shown that the treatment of eucalyptus in very short rotation of 2 years with reform of stand every 6 years has a average cost of production higher than the traditional treatment of short rotation of 6 years with reform only at the age of 18. It was also observed that eucalyptus has a Production Cost on average of R$ 4,41 /Gj, lower than the elephant grass which is on average of R$ 5,44/Gj, which however has a higher annual capacity of dry matter production. The elephant grass has the possibility to compete with eucalyptus when a set of conditions is met: discount rate higher than or equal to 8%, High price of land, and elephant grass high volume production, greater than or equal to 35 tonnes of dry matter per hectare and year.

  2. Cost of myopic patients with and without myopic choroidal neovascularisation.

    Science.gov (United States)

    Ruiz-Moreno, J M; Roura, M

    2016-06-01

    To study the costs associated with high myopia (HM) with choroidal neovascularisation (mCNV) or without mCNV. Observational, retrospective, cross-sectional, and multicentre study (HM and mCNV) conducted on adult patients. Annualised medical direct cost (MDC) from the perspective of the National Health System, the non-medical direct cost (nMDC) from the patient perspective, and productivity losses were calculated. A total of 137 mCNV and 48 HM patients were included (mean age [SD]: 55.1 [2.8] vs. 54.7 [13.8]; P=.2), with 80% women in both groups. The observation time (months) ranged from 17.9 (9.6) right eye (RE) and 20.0 (9.7), left eye (LE) in mCNV and 47.1 (21.5) RE/45.5 (20.7) LE in MM. A higher percentage of emergency room visits was observed in mCNV vs. HM patients (41.7 vs. 25%; P=.06) and retinal specialists (91.2 vs. 77.1%; P=.01). The MDC was higher in mCNV: € 1,985 (95% CI: 1772-2198) vs. € 356 (251-480) HM, P.4. The number of affected eyes, the follow-up time, and the mCNV were factors associated with direct costs. The impact on work productivity was higher in mCNV (quite/very concerned): 27.7 vs. 10.4% HM. The mCNV showed a significant association with activity impairment (OR: 3.47, 95% CI: 10.101-1.195). mCNV involves higher medical costs than HM. In addition, mCNV patients have a greater need of care and assistive devices, and greater impact of the disease in their work productivity. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  3. The Value of Negotiating Cost-Based Transfer Prices

    Directory of Open Access Journals (Sweden)

    Anne Chwolka

    2010-10-01

    Full Text Available This paper analyzes the potential of one-step transfer prices based on either variable or full costs for coordinating decentralized production and quality-improving investment decisions. Transfer prices based on variable costs fail to induce investments on the upstream stage. In contrast, transfer prices based on full costs provide strong investment incentives for the upstream divisions. However, they fail to coordinate the investment decisions. We show that negotiations prevent such coordination failure. In particular, we find that the firm benefits from a higher degree of decentralization so that total profit increases in the number of parameters being subject to negotiations.

  4. Risk factor and cost accounting analysis for dialysis patients in Taiwan.

    Science.gov (United States)

    Su, Bin-Guang; Tsai, Kai-Li; Yeh, Shu-Hsing; Ho, Yi-Yi; Liu, Shin-Yi; Rivers, Patrick A

    2010-05-01

    According to the 2004 US Renal Data System's annual report, the incidence rate of chronic renal failure in Taiwan increased from 120 to 352 per million populations between 1990 and 2003. This incidence rate is the highest in the world. The prevalence rate, which ranks number two in the world (Japan ranks number one), also increased from 384 to 1630 per million populations. Based on 2005 Taiwan national statistics, there were 52,958 end-stage renal disease (ESRD) patients receiving routine dialysis treatment. This number, which comprised less than 0.2% of the total population and consumed $2.6 billion New Taiwan dollars, was more than 6.12% of the total annual spending of national health insurance during 2005. Dialysis expenditures for patients with ESRD rank the highest among all major injuries (traumas) and diseases. This article identifies and discusses the risk factors associated with consumption of medical resources during dialysis. Instead of using reimbursement data to estimate cost, as seen in previous studies, this study uses cost data within organizations and focuses on evaluating and predicting the resource consumption pattern for dialysis patients with different risk factors. Multiple regression analysis was used to identify 23 risk factors for routine dialysis patients. Of these risk factors, six were associated with the increase of dialysis cost: age (i.e. 75 years old and older), liver function disorder, hypertension, bile-duct disorder, cancer and high blood lipids. Patients with liver function disorder incurred much higher costs for injection medication and supplies. Hypertensive patients incurred higher costs for injection medication, supplies and oral medication. Patients with bile-duct disorder incurred a significant difference in check-up costs (i.e. costs were higher for those aged 75 years and older than those who were younger than 30 years of age). Cancer patients also incurred significant differences in cost of medical supplies. Patients

  5. Capital Regulation, the Cost of Financial Intermediation and Bank Profitability: Evidence from Bangladesh

    Directory of Open Access Journals (Sweden)

    Changjun Zheng

    2017-04-01

    Full Text Available In response to the recent global financial crisis, the regulatory authorities in many countries have imposed stringent capital requirements in the form of the BASEL III Accord to ensure financial stability. On the other hand, bankers have criticized new regulation on the ground that it would enhance the cost of funds for bank borrowers and deteriorate the bank profitability. In this study, we examine the impact of capital requirements on the cost of financial intermediation and bank profitability using a panel dataset of 32 Bangladeshi banks over the period from 2000 to 2015. By employing a dynamic panel generalized method of moments (GMM estimator, we find robust evidence that higher bank regulatory capital ratios reduce the cost of financial intermediation and increase bank profitability. The results hold when we use equity to total assets ratio as an alternative measure of bank capital. We also observe that switching from BASEL I to BASEL II has no measurable impact on the cost of financial intermediation and bank profitability in Bangladesh. In the empirical analysis, we further observe that higher bank management and cost efficiencies are associated with the lower cost of financial intermediation and higher bank profitability. These results have important implications for bank regulators, academicians, and bankers.

  6. Environmental costs of fossil fuel energy production

    International Nuclear Information System (INIS)

    Riva, A.; Trebeschi, C.

    1997-01-01

    The costs of environmental impacts caused by fossil fuel energy production are external to the energy economy and normally they are not reflected in energy prices. To determine the environmental costs associated with an energy source a detailed analysis of all environmental impacts of the complete energy cycle is required. The economic evaluation of environmental damages is presented caused by atmospheric emissions produced by fossil fuel combustion for different uses. Considering the emission factors of sulphur oxides, nitrogen oxides, dust and carbon dioxide and the economic evaluation of their environmental damages reported in literature, a range of environmental costs associated with different fossil fuels and technologies is presented. A comparison of environmental costs resulting from atmospheric emissions produced by fossil-fuel combustion for energy production shows that natural gas has a significantly higher environmental value than other fossil fuels. (R.P.)

  7. Intensive treatment for adults with anorexia nervosa: The cost of weight restoration.

    Science.gov (United States)

    Guarda, Angela S; Schreyer, Colleen C; Fischer, Laura K; Hansen, Jennifer L; Coughlin, Janelle W; Kaminsky, Michael J; Attia, Evelyn; Redgrave, Graham W

    2017-03-01

    Weight restoration in anorexia nervosa (AN) is associated with lower relapse risk; however rate of weight gain and percent of patients achieving weight restoration (BMI ≥ 19 at discharge) vary among treatment programs. We compared both cost/pound of weight gained and cost of weight restoration in a hospital-based inpatient (IP)-partial hospitalization (PH) eating disorders program to estimates of these costs for residential treatment. All adult first admissions to the IP-PH program with AN (N = 314) from 2003 to 2015 were included. Cost of care was based on hospital charges, rates of weight gain, and weight restoration data. Results were compared with residential treatment costs extracted from a national insurance claims database and published weight gain data. Average charge/day in the IP-PH program was $2295 for IP and $1567 for PH, yielding an average cost/pound gained of $4089 and $7050, respectively, with 70% of patients achieving weight restoration. Based on published mean weight gain data and conservative cost/day estimates, residential treatment is associated with higher cost/pound, and both higher cost and lower likelihood of weight restoration for most patients. The key metrics used in this study are recommended for comparing the cost-effectiveness of intensive treatment programs for patients with AN. © 2017 Wiley Periodicals, Inc.

  8. Behaviour in O of the Neural Networks Training Cost

    DEFF Research Database (Denmark)

    Goutte, Cyril

    1998-01-01

    We study the behaviour in zero of the derivatives of the cost function used when training non-linear neural networks. It is shown that a fair number offirst, second and higher order derivatives vanish in zero, validating the belief that 0 is a peculiar and potentially harmful location. These calc......We study the behaviour in zero of the derivatives of the cost function used when training non-linear neural networks. It is shown that a fair number offirst, second and higher order derivatives vanish in zero, validating the belief that 0 is a peculiar and potentially harmful location....... These calculations arerelated to practical and theoretical aspects of neural networks training....

  9. [Cost of intensive care in a German hospital: cost-unit accounting based on the InEK matrix].

    Science.gov (United States)

    Martin, J; Neurohr, C; Bauer, M; Weiss, M; Schleppers, A

    2008-05-01

    The aim of this study was to determine the actual cost per intensive care unit (ICU) day in Germany based on routine data from an electronic patient data management system as well as analysis of cost-driving factors. A differentiation between days with and without mechanical ventilation was performed. On the ICU of a German focused-care hospital (896 beds, 12 anesthesiology ICU beds), cost per treatment day was calculated with or without mechanical ventilation from the perspective of the hospital. Costs were derived retrospectively with respect to the period between January and October 2006 by cost-unit accounting based on routine data collected from the ICU patients. Patients with a length of stay of at least 2 days on the ICU were included. Demographic, clinical and economical data were analyzed for patient characterization. Data of 407 patients (217 male and 190 female) were included in the analysis, of which 159 patients (100 male, 59 female) were completely or partially mechanically ventilated. The mean simplified acute physiology (SAPS) II score at the onset of ICU stay was 28.2. Average cost per ICU day was 1,265 EUR and costs for ICU days with and without mechanical ventilation amounted to 1,426 EUR and 1,145 EUR, respectively. Personnel costs (50%) showed the largest cost share followed by drugs plus medicinal products (18%) and infrastructure (16%). For the first time, a cost analysis of intensive care in Germany was performed with routine data based on the matrix of the institute for reimbursement in hospitals (InEK). The results revealed a higher resource use on the ICU than previously expected. The large share of personnel costs on the ICU was evident but is comparable to other medical departments in the hospital. The need for mechanical ventilation increases the daily costs of resources by approximately 25%.

  10. Accounting for the relationship between per diem cost and LOS when estimating hospitalization costs.

    Science.gov (United States)

    Ishak, K Jack; Stolar, Marilyn; Hu, Ming-yi; Alvarez, Piedad; Wang, Yamei; Getsios, Denis; Williams, Gregory C

    2012-12-01

    Hospitalization costs in clinical trials are typically derived by multiplying the length of stay (LOS) by an average per-diem (PD) cost from external sources. This assumes that PD costs are independent of LOS. Resource utilization in early days of the stay is usually more intense, however, and thus, the PD cost for a short hospitalization may be higher than for longer stays. The shape of this relationship is unlikely to be linear, as PD costs would be expected to gradually plateau. This paper describes how to model the relationship between PD cost and LOS using flexible statistical modelling techniques. An example based on a clinical study of clevidipine for the treatment of peri-operative hypertension during hospitalizations for cardiac surgery is used to illustrate how inferences about cost-savings associated with good blood pressure (BP) control during the stay can be affected by the approach used to derive hospitalization costs.Data on the cost and LOS of hospitalizations for coronary artery bypass grafting (CABG) from the Massachusetts Acute Hospital Case Mix Database (the MA Case Mix Database) were analyzed to link LOS to PD cost, factoring in complications that may have occurred during the hospitalization or post-discharge. The shape of the relationship between LOS and PD costs in the MA Case Mix was explored graphically in a regression framework. A series of statistical models including those based on simple logarithmic transformation of LOS to more flexible models using LOcally wEighted Scatterplot Smoothing (LOESS) techniques were considered. A final model was selected, using simplicity and parsimony as guiding principles in addition traditional fit statistics (like Akaike's Information Criterion, or AIC). This mapping was applied in ECLIPSE to predict an LOS-specific PD cost, and then a total cost of hospitalization. These were then compared for patients who had good vs. poor peri-operative blood-pressure control. The MA Case Mix dataset included data

  11. Accounting for the relationship between per diem cost and LOS when estimating hospitalization costs

    Directory of Open Access Journals (Sweden)

    Ishak K

    2012-12-01

    Full Text Available Abstract Background Hospitalization costs in clinical trials are typically derived by multiplying the length of stay (LOS by an average per-diem (PD cost from external sources. This assumes that PD costs are independent of LOS. Resource utilization in early days of the stay is usually more intense, however, and thus, the PD cost for a short hospitalization may be higher than for longer stays. The shape of this relationship is unlikely to be linear, as PD costs would be expected to gradually plateau. This paper describes how to model the relationship between PD cost and LOS using flexible statistical modelling techniques. Methods An example based on a clinical study of clevidipine for the treatment of peri-operative hypertension during hospitalizations for cardiac surgery is used to illustrate how inferences about cost-savings associated with good blood pressure (BP control during the stay can be affected by the approach used to derive hospitalization costs. Data on the cost and LOS of hospitalizations for coronary artery bypass grafting (CABG from the Massachusetts Acute Hospital Case Mix Database (the MA Case Mix Database were analyzed to link LOS to PD cost, factoring in complications that may have occurred during the hospitalization or post-discharge. The shape of the relationship between LOS and PD costs in the MA Case Mix was explored graphically in a regression framework. A series of statistical models including those based on simple logarithmic transformation of LOS to more flexible models using LOcally wEighted Scatterplot Smoothing (LOESS techniques were considered. A final model was selected, using simplicity and parsimony as guiding principles in addition traditional fit statistics (like Akaike’s Information Criterion, or AIC. This mapping was applied in ECLIPSE to predict an LOS-specific PD cost, and then a total cost of hospitalization. These were then compared for patients who had good vs. poor peri-operative blood

  12. Development of cost-benefit analysis system

    International Nuclear Information System (INIS)

    Shiba, Tsuyoshi; Mishima, Tetsuya; Yuyama, Tomonori; Suzuki, Atsushi

    2001-01-01

    In order to promote the FDR development, it is necessary to see various benefits brought by introduction of FBR from multiple perspectives and have a good grasp of such benefits quantitatively and an adequate R and D investment scale which corresponds with them. In this study, the structured prototype in the previous study was improved to be able to perform cost-benefit analysis. An example of improvement made in the system is addition of subroutine used for comparison between new energy and benefits brought by introduction of FBR with special emphasis on addition of logic for analyzing externality about the new energy. Other improvement examples are modification of the Conventional Year Expense Ratio method of power generation cost to Average Durable Year Cost method, addition of database function and turning input data into database, and reviewing idea on cost by the type of waste material and price of uranium. The cost-benefit analysis system was also restructured utilizing Microsoft ACCESS so that it should have a data base function. As the result of the improvement mentioned above, we expect that the improved cost-benefit analysis system will have higher generality than the system before; therefore, great deal of benefits brought by application of the system in the future is expected. (author)

  13. TRANSACTION COSTS AND MARKET IMPACT IN INVESTMENT MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Marek Kociński

    2015-05-01

    Full Text Available The aim of this article is to analyse the major sources of transaction costs in financial markets, in particular to find the amounts of such costs on the Warsaw Stock Exchange (WSE. Sources of transaction costs are considered: commissions, bid-ask spread and market impact. The commissions are only briefly described since they are explicitly stated and easily measured. More attention is paid to the bid-ask spread which is one of the main causes of trading costs. It is shown that the investor who wants to outperform the Polish market should usually expect a much higher bid-ask spread than it follows from the officially used calculations. Then it is demonstrated how historical spreads can be used in predicting their future values. This seems to be important from the practical point of view, since forecasting trading costs is a compelling task for financial managers. Next, market impact and market impact costs are considered. The practical method of measuring these is applied and discussed.

  14. Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition

    Directory of Open Access Journals (Sweden)

    Morales Eva

    2012-05-01

    Full Text Available Abstract Background We aimed to assess the hospital economic costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. Methods A retrospective study of all hospital admissions between January 1, 2005, and December 31, 2006 was carried out in a 420-bed, urban, tertiary-care teaching hospital in Barcelona (Spain. All patients with a first positive clinical culture for P. aeruginosa more than 48 h after admission were included. Patient and hospitalization characteristics were collected from hospital and microbiology laboratory computerized records. According to antibiotic susceptibility, isolates were classified as non-resistant, resistant and multi-drug resistant. Cost estimation was based on a full-costing cost accounting system and on the criteria of clinical Activity-Based Costing methods. Multivariate analyses were performed using generalized linear models of log-transformed costs. Results Cost estimations were available for 402 nosocomial incident P. aeruginosa positive cultures. Their distribution by antibiotic susceptibility pattern was 37.1% non-resistant, 29.6% resistant and 33.3% multi-drug resistant. The total mean economic cost per admission of patients with multi-drug resistant P. aeruginosa strains was higher than that for non-resistant strains (15,265 vs. 4,933 Euros. In multivariate analysis, resistant and multi-drug resistant strains were independently predictive of an increased hospital total cost in compared with non-resistant strains (the incremental increase in total hospital cost was more than 1.37-fold and 1.77-fold that for non-resistant strains, respectively. Conclusions P. aeruginosa multi-drug resistance independently predicted higher hospital costs with a more than 70% increase per admission compared with non-resistant strains. Prevention of the nosocomial emergence and spread of antimicrobial resistant microorganisms is essential to limit the strong economic impact.

  15. Cost Optimal Design of a Single-Phase Dry Power Transformer

    Directory of Open Access Journals (Sweden)

    Raju Basak

    2015-08-01

    Full Text Available The Dry type transformers are preferred to their oil-immersed counterparts for various reasons, particularly because their operation is hazardless. The application of dry transformers was limited to small ratings in the earlier days. But now these are being used for considerably higher ratings.  Therefore, their cost-optimal design has gained importance. This paper deals with the design procedure for achieving cost optimal design of a dry type single-phase power transformer of small rating, subject to usual design constraints on efficiency and voltage regulation. The selling cost for the transformer has been taken as the objective function. Only two key variables have been chosen, the turns/volt and the height: width ratio of window, which affects the cost function to high degrees. Other variables have been chosen on the basis of designers’ experience. Copper has been used as conductor material and CRGOS as core material to achieve higher efficiency, lower running cost and compact design. The electrical and magnetic loadings have been kept at their maximum values without violating the design constraints. The optimal solution has been obtained by the method of exhaustive search using nested loops.

  16. Life-cycle cost trade studies for hardness assurance

    International Nuclear Information System (INIS)

    Millward, D.G.

    1996-01-01

    Based on hardness assurance (HA) cost trade studies conducted on a low-cost/high-volume tactical military system with moderate radiation environments, conventional strategies for design hardening and HA can result in higher life-cycle costs (LCC) than alternate approaches. The trade studies used variables designed to investigate LCC as a function of several critical parameters, including semiconductor procurement option, system quantity, HA testing option,a nd other variables. An LCC model and sample problem are included to illustrate the key results. Following the results of the trade studies, limitations of the simplified cost model are presented, the relationship of these results to current procurement practices are discussed, and the application of the results to modern military and commercial systems is discussed

  17. Methane Production of Full-Scale Anaerobic Digestion Plants Calculated from Substrate’s Biomethane Potentials Compares Well with the One Measured On-Site

    Energy Technology Data Exchange (ETDEWEB)

    Holliger, Christof, E-mail: christof.holliger@epfl.ch [Laboratory for Environmental Biotechnology, School for Architecture, Civil and Environmental Engineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne (Switzerland); Fruteau de Laclos, Hélène [Methaconsult, Préverenges (Switzerland); Hack, Gabrielle [Laboratory for Environmental Biotechnology, School for Architecture, Civil and Environmental Engineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne (Switzerland)

    2017-06-09

    Biomethane potential (BMP) tests are used to determine the amount of methane that can be produced from organic materials in order to design different components of full-scale anaerobic digestion (AD) plants such as size of the digesters and units exploiting the produced biogas. However, little is known on how well BMPs compare with biogas production from the same organic materials in full-scale installations. In this study, two AD plants were chosen to carry out such comparisons, a dry AD plant treating green waste from urban areas and food waste from restaurants and supermarkets, and a liquid AD plant treating waste sludge from wastewater treatment and seven additional organic wastes. The BMPs of multiple samples of the individual organic materials collected during a period of 7–9 months were determined. Separate tests of mixtures of organic materials confirmed that the BMP of the mixtures can be calculated by adding the BMPs of the individual materials. The weekly methane production during the investigated periods was calculated from the full-scale installation data on the feeding of the digesters and the BMPs of each substrate fed into the digesters and compared with the weekly methane production measured on-site. The latter was calculated from the most accurately measured entity, either the electricity or the volume of purified biomethane injected into the grid. The weekly methane production rates calculated from BMPs and the one measured on-site were very similar and followed the same pattern. Some exceptions could be explained by, e.g., an overload of the full-scale installation. The measured weekly methane production accounted for 94.0 ± 6.8 and 89.3 ± 5.7% of the calculated weekly methane production for the wet and dry AD plant, respectively. For 26 out of 29 weeks, the calculated weekly methane production overestimated the measured one in the case of the wet AD plant and for 37 out of 39 weeks for the dry AD plant. Based on these results, it is

  18. Methane Production of Full-Scale Anaerobic Digestion Plants Calculated from Substrate’s Biomethane Potentials Compares Well with the One Measured On-Site

    International Nuclear Information System (INIS)

    Holliger, Christof; Fruteau de Laclos, Hélène; Hack, Gabrielle

    2017-01-01

    Biomethane potential (BMP) tests are used to determine the amount of methane that can be produced from organic materials in order to design different components of full-scale anaerobic digestion (AD) plants such as size of the digesters and units exploiting the produced biogas. However, little is known on how well BMPs compare with biogas production from the same organic materials in full-scale installations. In this study, two AD plants were chosen to carry out such comparisons, a dry AD plant treating green waste from urban areas and food waste from restaurants and supermarkets, and a liquid AD plant treating waste sludge from wastewater treatment and seven additional organic wastes. The BMPs of multiple samples of the individual organic materials collected during a period of 7–9 months were determined. Separate tests of mixtures of organic materials confirmed that the BMP of the mixtures can be calculated by adding the BMPs of the individual materials. The weekly methane production during the investigated periods was calculated from the full-scale installation data on the feeding of the digesters and the BMPs of each substrate fed into the digesters and compared with the weekly methane production measured on-site. The latter was calculated from the most accurately measured entity, either the electricity or the volume of purified biomethane injected into the grid. The weekly methane production rates calculated from BMPs and the one measured on-site were very similar and followed the same pattern. Some exceptions could be explained by, e.g., an overload of the full-scale installation. The measured weekly methane production accounted for 94.0 ± 6.8 and 89.3 ± 5.7% of the calculated weekly methane production for the wet and dry AD plant, respectively. For 26 out of 29 weeks, the calculated weekly methane production overestimated the measured one in the case of the wet AD plant and for 37 out of 39 weeks for the dry AD plant. Based on these results, it is

  19. In Search of a New Paradigm for Higher Education

    Science.gov (United States)

    Schejbal, David

    2012-01-01

    In this essay I argue that online education, artificial intelligence, and market pressures are driving higher education to adopt the industrial model and to find a new paradigm for delivering education at low costs. In addition, there is tremendous pressure from the federal government to make universities more accountable while making higher…

  20. How much does an antiinflammatory treatment cost?

    Directory of Open Access Journals (Sweden)

    S. Adami

    2011-06-01

    Full Text Available NSAIDs are among the most popular drugs in the world for their efficacy in controlling pain and acute and chronic inflammation. The efficacy of these therapies is hampered by their safety profile, in particular regarding the gastroenteric tract. The NSAIDs’ side effects may heavily influence the health of the single patient and the economy of the health systems. The pharmacoeconomic evaluation of antinflammatory treatment usually considers, in addition to the drug purchase prize, also the shadow costs. This cost is mainly due to the management and prevention of gastropathy. Coxibs, even if more expensive, may become cost-effective for their better gastronteric safety. As a matter of fact, coxib treatment can be considered equivalent to a treatment with NSAID plus PPI. However, the first requirement of these drugs, that should control pain, must be the efficacy and not only safety. In this case the NNT (Number Needed to Treat is a good marker of efficacy. To calculate the real cost we must pay to reach the target (pain resolution in one patient, we can multiply NNT for the prize of a specific drug. The total cost will depend on drug prize (the cheaper, the better and on the efficacy expressed by NNT (the lower, the better. In a recent meta-analysis, the NNT of several antinflammatory drugs has been calculated. When the treatment cost was adjusted for its efficacy (NNT, the difference in favour of NSAIDs became so little to disappear because of the higher safety of coxibs (especially of etoricoxiband the possibility to reach antinflammatory and analgesic doses that are difficult to obtain with NSAIDs. Moreover, if also the cost of gastroprotection is considered, the economic impact of NSAIDs can be much higher. In conclusion the pharmacoeconomic analysis of an antinflammatory therapy cannot be based only on safety issues but also on efficacy evaluation that is the main effect we ask to these drugs.

  1. Receptive females mitigate costs of sexual conflict.

    Science.gov (United States)

    Harano, T

    2015-02-01

    Males typically gain fitness from multiple mating, whereas females often lose fitness from numerous mating, potentially leading to sexual conflict over mating. This conflict is expected to favour the evolution of female resistance to mating. However, females may incur male harassment if they refuse to copulate; thus, greater female resistance may increase costs imposed by males. Here, I show that the evolution of resistance to mating raises fitness disadvantages of interacting with males when mating is harmful in female adzuki bean beetles, Callosobruchus chinensis. Females that were artificially selected for higher and lower remating propensity evolved to accept and resist remating, respectively. Compared with females that evolved to accept remating, females that evolved to resist it suffered higher fitness costs from continuous exposure to males. The costs of a single mating measured by the effect on longevity did not differ among selection line females. This study indicates that receptive rather than resistant females mitigate the fitness loss resulting from sexual conflict, suggesting that even though mating is harmful, females can evolve to accept additional mating. © 2014 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2014 European Society For Evolutionary Biology.

  2. Cost-effectiveness of aliskiren in type 2 diabetes, hypertension, and albuminuria

    DEFF Research Database (Denmark)

    Delea, Thomas E; Sofrygin, Oleg; Palmer, James L

    2009-01-01

    2 diabetes, hypertension, and albuminuria. The cost-effectiveness of this therapy, however, is unknown. Here, we used a Markov model to project progression to ESRD, life years, quality-adjusted life years, and lifetime costs for aliskiren plus losartan versus losartan. We used data from the AVOID...... health care costs increased by $2952, reflecting the higher pharmacy costs of aliskiren and losartan ($7769), which were partially offset by savings in costs of ESRD ($4860). We estimated the cost-effectiveness of aliskiren to be $30,500 per quality-adjusted life year gained. In conclusion, adding...... aliskiren to losartan and optimal therapy in patients with type 2 diabetes, hypertension, and albuminuria may be cost-effective from a US health care system perspective....

  3. The external costs of a sedentary life-style.

    Science.gov (United States)

    Keeler, E B; Manning, W G; Newhouse, J P; Sloss, E M; Wasserman, J

    1989-01-01

    Using data from the National Health Interview Survey and the RAND Health Insurance Experiment, we estimated the external costs (costs borne by others) of a sedentary life-style. External costs stem from additional payments received by sedentary individuals from collectively financed programs such as health insurance, sick-leave coverage, disability insurance, and group life insurance. Those with sedentary life-styles incur higher medical costs, but their life expectancy at age 20 is 10 months less so they collect less public and private pensions. The pension costs come late in life, as do some of the medical costs, and so the estimate of the external cost is sensitive to the discount rate used. At a 5 percent rate of discount, the lifetime subsidy from others to those with a sedentary life style is $1,900. Our estimate of the subsidy is also sensitive to the assumed effect of exercise on mortality. The subsidy is a rationale for public support of recreational facilities such as parks and swimming pools and employer support of programs to increase exercise. PMID:2502036

  4. Influences of misprediction costs on solar flare prediction

    Science.gov (United States)

    Huang, Xin; Wang, HuaNing; Dai, XingHua

    2012-10-01

    The mispredictive costs of flaring and non-flaring samples are different for different applications of solar flare prediction. Hence, solar flare prediction is considered a cost sensitive problem. A cost sensitive solar flare prediction model is built by modifying the basic decision tree algorithm. Inconsistency rate with the exhaustive search strategy is used to determine the optimal combination of magnetic field parameters in an active region. These selected parameters are applied as the inputs of the solar flare prediction model. The performance of the cost sensitive solar flare prediction model is evaluated for the different thresholds of solar flares. It is found that more flaring samples are correctly predicted and more non-flaring samples are wrongly predicted with the increase of the cost for wrongly predicting flaring samples as non-flaring samples, and the larger cost of wrongly predicting flaring samples as non-flaring samples is required for the higher threshold of solar flares. This can be considered as the guide line for choosing proper cost to meet the requirements in different applications.

  5. Links between social environment and health care utilization and costs.

    Science.gov (United States)

    Brault, Marie A; Brewster, Amanda L; Bradley, Elizabeth H; Keene, Danya; Tan, Annabel X; Curry, Leslie A

    2018-01-01

    The social environment influences health outcomes for older adults and could be an important target for interventions to reduce costly medical care. We sought to understand which elements of the social environment distinguish communities that achieve lower health care utilization and costs from communities that experience higher health care utilization and costs for older adults with complex needs. We used a sequential explanatory mixed methods approach. We classified community performance based on three outcomes: rate of hospitalizations for ambulatory care sensitive conditions, all-cause risk-standardized hospital readmission rates, and Medicare spending per beneficiary. We conducted in-depth interviews with key informants (N = 245) from organizations providing health or social services. Higher performing communities were distinguished by several aspects of social environment, and these features were lacking in lower performing communities: 1) strong informal support networks; 2) partnerships between faith-based organizations and health care and social service organizations; and 3) grassroots organizing and advocacy efforts. Higher performing communities share similar social environmental features that complement the work of health care and social service organizations. Many of the supportive features and programs identified in the higher performing communities were developed locally and with limited governmental funding, providing opportunities for improvement.

  6. Partial and incremental PCMH practice transformation: implications for quality and costs.

    Science.gov (United States)

    Paustian, Michael L; Alexander, Jeffrey A; El Reda, Darline K; Wise, Chris G; Green, Lee A; Fetters, Michael D

    2014-02-01

    To examine the associations between partial and incremental implementation of the Patient Centered Medical Home (PCMH) model and measures of cost and quality of care. We combined validated, self-reported PCMH capabilities data with administrative claims data for a diverse statewide population of 2,432 primary care practices in Michigan. These data were supplemented with contextual data from the Area Resource File. We measured medical home capabilities in place as of June 2009 and change in medical home capabilities implemented between July 2009 and June 2010. Generalized estimating equations were used to estimate the mean effect of these PCMH measures on total medical costs and quality of care delivered in physician practices between July 2009 and June 2010, while controlling for potential practice, patient cohort, physician organization, and practice environment confounders. Based on the observed relationships for partial implementation, full implementation of the PCMH model is associated with a 3.5 percent higher quality composite score, a 5.1 percent higher preventive composite score, and $26.37 lower per member per month medical costs for adults. Full PCMH implementation is also associated with a 12.2 percent higher preventive composite score, but no reductions in costs for pediatric populations. Incremental improvements in PCMH model implementation yielded similar positive effects on quality of care for both adult and pediatric populations but were not associated with cost savings for either population. Estimated effects of the PCMH model on quality and cost of care appear to improve with the degree of PCMH implementation achieved and with incremental improvements in implementation. © Health Research and Educational Trust.

  7. Thoracic surgical resident education: a costly endeavor.

    Science.gov (United States)

    Calhoon, John H; Baisden, Clint; Holler, Ben; Hicks, George L; Bove, Ed L; Wright, Cameron D; Merrill, Walter H; Fullerton, Dave A

    2014-12-01

    We sought to define an accurate measure of thoracic surgical education costs. Program directors from six distinct and differently sized and geographically located thoracic surgical training programs used a common template to provide estimates of resident educational costs. These data were reviewed, clarifying questions or discrepancies when noted and using best estimates when exact data were unavailable. Subsequently, a composite of previously published cost-estimation products was used to capture accurate cost data. Data were then compiled and averaged to provide an accurate picture of all costs associated with thoracic surgical education. Before formal accounting was performed, the estimated average for all programs was approximately $250,000 per year per resident. However, when formal evaluations by the six programs were performed, the annual cost of resident education ranged from $330,000 to $667,000 per year per resident. The average cost of $483,000 per year was almost double the initial estimates. Variability was noted by region and size of program. Faculty teaching costs varied from $208,000 to $346,000 per year. Simulation costs ranged from $0 to $80,000 per year. Resident savings to program ranged from $0 to $135,000 per year and averaged $37,000 per year per resident. Thoracic surgical education costs are considerably higher than initial estimates from program directors and probably represent an unappreciated source of financial burden for cardiothoracic surgical educational programs. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. A Risky Business? Mature Working-Class Women Students and Access to Higher Education.

    Science.gov (United States)

    Reay, Diane

    2003-01-01

    Examines the experiences of 12 working class women attending an Access course at an inner city further education college. Risks and costs involved in transitioning to higher education were evident in the women's narratives. Material and cultural factors inhibited their access to higher education. The desire to "give something back"…

  9. Direct health services costs of providing assisted reproduction services in older women.

    Science.gov (United States)

    Maheshwari, Abha; Scotland, Graham; Bell, Jacqueline; McTavish, Alison; Hamilton, Mark; Bhattacharya, Siladitya

    2010-02-01

    To assess the total health service costs incurred for each live birth achieved by older women undergoing IVF compared with costs in younger women. Retrospective cross-sectional analysis. In vitro fertilization unit and maternity hospital in a tertiary care setting. Women who underwent their first cycle of IVF between 1997 and 2006. Bottom-up costs were calculated for all interventions in the IVF cycle. Early pregnancy and antenatal care costs were obtained from National Health Service reference costs, Information Services Division Scotland, and local departmental costs. Cost per live birth. The mean cost per live birth (95% confidence interval [CI]) in women undergoing IVF at the age of > or =40 years was pound 40,320 (pound 27,105- pound 65,036), which is >2.5 times higher than those aged 35-39 years (pound 17,096 [pound 15,635- pound 18,937]). The cost per ongoing pregnancy was almost three times in women aged > or =40 (pound 31,642 [pound 21,241- pound 58,979]) compared with women 35-39 years of age (pound 11,300 [pound 10,006- pound 12,938]). The cost of a live birth after IVF rises significantly at the age of 40 years owing to lower success rates. Most of the extra cost is due to the low success of IVF treatment, but some of it is due to higher rates of early pregnancy loss. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Higher education and spatial (im)mobility: nontraditional students and living at home

    OpenAIRE

    Hazel Christie

    2007-01-01

    I investigate the mobility decisions of students going into higher education in the UK, and look particularly at the circumstances under which students in one higher education market chose to live at home and their experiences of attending a local university. As more young people from nontraditional backgrounds are encouraged to participate in higher education, and as the financial costs of attending are increasingly borne by students and their families, more students are choosing to stay at ...

  11. Hidden costs of nuclear power

    International Nuclear Information System (INIS)

    England, R.W.

    1979-01-01

    Mr. England contends that these hidden costs add up to a figure much higher than those that appear in the electric utilities' profit and loss account - costs that are borne by Federal taxpayers, by nuclear industry workers, and by all those people who must share their environment with nuclear facilities. Costs he details are additional deaths and illnesses resulting from exposure to radiation, and the use of tax dollars to clean up the lethal garbage produced by those activities. He asserts that careless handling of uranium ore and mill tailings in past years has apparently resulted in serious public health problems in those mining communities. In another example, Mr. England states that the failure to isolate uranium tailings physically from their environment has probably contributed to an acute leukemia rate in Mesa County, Colorado. He mentions much of the technology development for power reactors being done by the Federal government, not by private reactor manufacturers - thus, again, hidden costs that do not show up in electric bills of customers. The back end of the nuclear fuel cycle as a place for Federally subsidized research and development is discussed briefly. 1 figure, 2 tables

  12. Energy cost of seed drying

    Directory of Open Access Journals (Sweden)

    Weerachet Jittanit

    2017-11-01

    Full Text Available In this work, the energy costs of drying corn, rice and wheat seeds between 3 drying options were compared. They consisted of 1 two-stage drying by using fluidised bed dryer (FBD in the 1st stage and in-store dryer (ISD in the 2nd stage, 2 single-stage drying by fixed bed dryer (FXD and 3 two-stage drying by using FXD in the 1st  stage and ISD in the 2nd  stage. The drying conditions selected for comparison were proved to be safe for seed viability by the previous studies. The results showed that the drying options 2 and 3 consumed less energy than option 1. However, the benefits from lower energy cost must be weighed against some advantages of using FBD. Furthermore, it appeared that running the burners of FXD and ISD for warming up the ambient air during humid weather condition could shorten drying time significantly with a little higher energy cost.

  13. Health care resource use and costs among patients with cushing disease.

    Science.gov (United States)

    Swearingen, Brooke; Wu, Ning; Chen, Shih-Yin; Pulgar, Sonia; Biller, Beverly M K

    2011-01-01

    To assess health care costs associated with Cushing disease and to determine changes in overall and comorbidity-related costs after surgical treatment. In this retrospective cohort study, patients with Cushing disease were identified from insurance claims databases by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes for Cushing syndrome (255.0) and either benign pituitary adenomas (227.3) or hypophysectomy (07.6×) between 2004 and 2008. Each patient with Cushing disease was age- and sex-matched with 4 patients with nonfunctioning pituitary adenomas and 10 population control subjects. Comorbid conditions and annual direct health care costs were assessed within each calendar year. Postoperative changes in health care costs and comorbidity-related costs were compared between patients presumed to be in remission and those with presumed persistent disease. Of 877 identified patients with Cushing disease, 79% were female and the average age was 43.4 years. Hypertension, diabetes mellitus, and hyperlipidemia were more common among patients with Cushing disease than in patients with nonfunctioning pituitary adenomas or in control patients (PCushing disease had significantly higher total health care costs (2008: $26 440 [Cushing disease] vs $13 708 [nonfunctioning pituitary adenomas] vs $5954 [population control], Pdisease-related costs with remission. A significant increase in postoperative health care costs was observed in those patients not in remission. Patients with Cushing disease had more comorbidities than patients with nonfunctioning pituitary adenomas or control patients and incurred significantly higher annual health care costs; these costs decreased after successful surgery and increased after unsuccessful surgery.

  14. Higher Education: A Time for Triage?

    Science.gov (United States)

    Lagowski, J. J.

    1995-10-01

    Higher education faces unprecedented challenges. The confluence of changing economic and demographic tends; new patterns of federal and state spending; more explicit expectations by students and their families for affordable, accessible education; and heightened scrutiny by those who claim a legitimate interest in higher education is inescapably altering the environment in which this system operates. Higher education will never again be as it was before. Further, many believe that tinkering around the margins is no longer an adequate response to the new demands. Fundamental change is deemed necessary to meet the challenge of this melange of pressures. A number of commentators have observed that political and corporate America have responded to their challenges by instituting a fundamental restructuring of those institutions. The medical community is also in the midst of a similar basic restructuring of the health care delivery system in this country. Now its education's turn. People are questioning the historically expressed mission of higher education. They make the claim that we cost too much, spend carelessly, teach poorly, plan myopically, and when questioned, act defensively. Educational administrators, from department chairs up, are confronted with the task of simultaneously reforming and cutting back. They have no choice. They must establish politically sophisticated priority settings and effect a hard-nosed reallocation of resources in a social environment where competing public needs have equivalent--or stronger--emotional pulls. Triage in a medical context involves confronting an emergency in which the demand for attention far outstrips available assistance by establishing a sequence of care in which one key individual orchestrates the application of harsh priorities which have been designed to maximize the number of survivors. In recent years, the decisions that have been made in some centers of higher education bear a striking similarity. The literature

  15. Inpatient Hospitalization Costs: A Comparative Study of Micronesians, Native Hawaiians, Japanese, and Whites in Hawai‘i

    Directory of Open Access Journals (Sweden)

    Megan Hagiwara

    2015-12-01

    Full Text Available Considerable interest exists in health care costs for the growing Micronesian population in the United States (US due to their significant health care needs, poor average socioeconomic status, and unique immigration status, which impacts their access to public health care coverage. Using Hawai‘i statewide impatient data from 2010 to 2012 for Micronesians, whites, Japanese, and Native Hawaiians (N = 162,152 hospitalizations, we compared inpatient hospital costs across racial/ethnic groups using multivariable models including age, gender, payer, residence location, and severity of illness (SOI. We also examined total inpatient hospital costs of Micronesians generally and for Medicaid specifically. Costs were estimated using standard cost-to-charge metrics overall and within nine major disease categories determined by All Patient Refined Diagnosis Related Groups. Micronesians had higher unadjusted hospitalization costs overall and specifically within several disease categories (including infectious and heart diseases. Higher SOI in Micronesians explained some, but not all, of these higher costs. The total cost of the 3486 Micronesian hospitalizations in the three-year study period was $58.1 million and 75% was covered by Medicaid; 23% of Native Hawaiian, 3% of Japanese, and 15% of white hospitalizations costs were covered by Medicaid. These findings may be of particular interests to hospitals, Medicaid programs, and policy makers.

  16. Extreme Cost Reductions with Multi-Megawatt Centralized Inverter Systems

    Energy Technology Data Exchange (ETDEWEB)

    Schwabe, Ulrich [Alencon LLC; Fishman, Oleg [Alencon LLC

    2015-03-20

    The objective of this project was to fully develop, demonstrate, and commercialize a new type of utility scale PV system. Based on patented technology, this includes the development of a truly centralized inverter system with capacities up to 100MW, and a high voltage, distributed harvesting approach. This system promises to greatly impact both the energy yield from large scale PV systems by reducing losses and increasing yield from mismatched arrays, as well as reduce overall system costs through very cost effective conversion and BOS cost reductions enabled by higher voltage operation.

  17. A utility/cost analysis of breast cancer risk prediction algorithms

    Science.gov (United States)

    Abbey, Craig K.; Wu, Yirong; Burnside, Elizabeth S.; Wunderlich, Adam; Samuelson, Frank W.; Boone, John M.

    2016-03-01

    Breast cancer risk prediction algorithms are used to identify subpopulations that are at increased risk for developing breast cancer. They can be based on many different sources of data such as demographics, relatives with cancer, gene expression, and various phenotypic features such as breast density. Women who are identified as high risk may undergo a more extensive (and expensive) screening process that includes MRI or ultrasound imaging in addition to the standard full-field digital mammography (FFDM) exam. Given that there are many ways that risk prediction may be accomplished, it is of interest to evaluate them in terms of expected cost, which includes the costs of diagnostic outcomes. In this work we perform an expected-cost analysis of risk prediction algorithms that is based on a published model that includes the costs associated with diagnostic outcomes (true-positive, false-positive, etc.). We assume the existence of a standard screening method and an enhanced screening method with higher scan cost, higher sensitivity, and lower specificity. We then assess expected cost of using a risk prediction algorithm to determine who gets the enhanced screening method under the strong assumption that risk and diagnostic performance are independent. We find that if risk prediction leads to a high enough positive predictive value, it will be cost-effective regardless of the size of the subpopulation. Furthermore, in terms of the hit-rate and false-alarm rate of the of the risk prediction algorithm, iso-cost contours are lines with slope determined by properties of the available diagnostic systems for screening.

  18. Impact of air pollution control costs on the cost and spatial arrangement of cellulosic biofuel production in the U.S.

    Science.gov (United States)

    Murphy, Colin W; Parker, Nathan C

    2014-02-18

    Air pollution emissions regulation can affect the location, size, and technology choice of potential biofuel production facilities. Difficulty in obtaining air pollutant emission permits and the cost of air pollution control devices have been cited by some fuel producers as barriers to development. This paper expands on the Geospatial Bioenergy Systems Model (GBSM) to evaluate the effect of air pollution control costs on the availability, cost, and distribution of U.S. biofuel production by subjecting potential facility locations within U.S. Clean Air Act nonattainment areas, which exceed thresholds for healthy air quality, to additional costs. This paper compares three scenarios: one with air quality costs included, one without air quality costs, and one in which conversion facilities were prohibited in Clean Air Act nonattainment areas. While air quality regulation may substantially affect local decisions regarding siting or technology choices, their effect on the system as a whole is small. Most biofuel facilities are expected to be sited near to feedstock supplies, which are seldom in nonattainment areas. The average cost per unit of produced energy is less than 1% higher in the scenarios with air quality compliance costs than in scenarios without such costs. When facility construction is prohibited in nonattainment areas, the costs increase by slightly over 1%, due to increases in the distance feedstock is transported to facilities in attainment areas.

  19. Effect of migration based on strategy and cost on the evolution of cooperation

    International Nuclear Information System (INIS)

    Li, Yan; Ye, Hang

    2015-01-01

    Highlights: •Propose a migration based on strategy and cost in the Prisoner’s Dilemma Game. •The level of cooperation without mutation is higher than that with mutation. •Increased costs have no effect on the level of cooperation without mutation. •The level of cooperation decreases with the increase in cost with mutation. •An optimal density value ρ resulting in the maximum level of cooperation exists. -- Abstract: Humans consider not only their own ability but also the environment around them during the process of migration. Based on this fact, we introduce migration based on strategy and cost into the Spatial Prisoner’s Dilemma Game on a two-dimensional grid. The migration means that agents cannot move when all of the neighbors are cooperators; otherwise, agents move with a probability related to payoff and cost. The result obtained by the computer simulation shows that the moving mechanism based on strategy and cost improves the level of cooperation in a wide parameter space. This occurs because movement based on strategy effectively keeps the cooperative clusters and because movement based on cost effectively regulates the rate of movement. Both types of movement provide a favorable guarantee for the evolution of stable cooperation under the mutation rate q = 0.0. In addition, we discuss the effectiveness of the migration mechanism in the evolution of cooperation under the mutation rate q = 0.001. The result indicates that a higher level of cooperation is obtained at a lower migration cost, whereas cooperation is suppressed at a higher migration cost. Our work may provide an effective method for understanding the emergence of cooperation in our society

  20. Pricing for Higher Education Institutions: A Value-Based Approach

    Science.gov (United States)

    Amir, Amizawati Mohd; Auzair, Sofiah Md; Maelah, Ruhanita; Ahmad, Azlina

    2016-01-01

    Purpose: The purpose of this paper is to propose the concept of higher education institutions (HEIs) offering educational services based on value for money. The value is determined based on customers' (i.e. students) expectations of the service and the costs in comparison to the competitors. Understanding the value and creating customer value are…

  1. Costs of occupational injuries and illnesses in Croatia.

    Science.gov (United States)

    Bađun, Marijana

    2017-03-01

    Apart from influencing the quality of life, occupational injuries and illnesses can pose a large economic burden to a society. There are many studies that estimate the costs of occupational injuries and illnesses in highly developed economies, but the evidence for other countries is scarce. This study aimed to estimate the financial costs of occupational injuries and illnesses to Croatian government and employers in 2015. Workers were excluded due to the lack of data. Costs were estimated by analysing available data sources on occupational health and safety. Financial costs were grouped in several categories: medical costs, productivity losses, disability pensions, compensation for physical impairment, administrative costs, and legal costs. Unlike in other studies, the costs of compliance with occupational safety and health regulations were also investigated. In 2015, financial costs to employers were twice higher than costs to the government (HRK 604.6 m vs HRK 297 m). Employers additionally covered around HRK 300 m of compliance costs. Taking into account that financial costs of occupational injuries and illnesses are significant, even without including the costs to workers, policy makers should put additional efforts into their prevention. A prerequisite is transparency in Croatian Health Insurance Fund's expenditures, as well as more detailed data on lost days from work by industries, causes of injury etc. Organisations in charge of occupational health and safety and policy makers should observe relevant statistics in monetary terms too.

  2. Performance and cost evaluation of health information systems using micro-costing and discrete-event simulation.

    Science.gov (United States)

    Rejeb, Olfa; Pilet, Claire; Hamana, Sabri; Xie, Xiaolan; Durand, Thierry; Aloui, Saber; Doly, Anne; Biron, Pierre; Perrier, Lionel; Augusto, Vincent

    2018-06-01

    Innovation and health-care funding reforms have contributed to the deployment of Information and Communication Technology (ICT) to improve patient care. Many health-care organizations considered the application of ICT as a crucial key to enhance health-care management. The purpose of this paper is to provide a methodology to assess the organizational impact of high-level Health Information System (HIS) on patient pathway. We propose an integrated performance evaluation of HIS approach through the combination of formal modeling using the Architecture of Integrated Information Systems (ARIS) models, a micro-costing approach for cost evaluation, and a Discrete-Event Simulation (DES) approach. The methodology is applied to the consultation for cancer treatment process. Simulation scenarios are established to conclude about the impact of HIS on patient pathway. We demonstrated that although high level HIS lengthen the consultation, occupation rate of oncologists are lower and quality of service is higher (through the number of available information accessed during the consultation to formulate the diagnostic). The provided method allows also to determine the most cost-effective ICT elements to improve the care process quality while minimizing costs. The methodology is flexible enough to be applied to other health-care systems.

  3. The cost of pressure ulcers in the UK.

    Science.gov (United States)

    Bennett, Gerry; Dealey, Carol; Posnett, John

    2004-05-01

    To estimate the annual cost of treating pressure ulcers in the UK. Costs were derived from a bottom-up methodology, based on the daily resources required to deliver protocols of care reflecting good clinical practice. Health and social care system in the UK. Patients developing a pressure ulcer. A bottom-up costing approach is used to estimate treatment cost per episode of care and per patient for ulcers of different grades and level of complications. Also, total treatment cost to the health and social care system in the UK. The cost of treating a pressure ulcer varies from pound 1,064 (Grade 1) to pound 10,551 (Grade 4). Costs increase with ulcer grade because the time to heal is longer and because the incidence of complications is higher in more severe cases. The total cost in the UK is pound 1.4- pound 2.1 billion annually (4% of total NHS expenditure). Most of this cost is nurse time. Pressure ulcers represent a very significant cost burden in the UK. Without concerted effort this cost is likely to increase in the future as the population ages. To the extent that pressure ulcers are avoidable, pressure damage may be indicative of clinical negligence and there is evidence that litigation could soon become a significant threat to healthcare providers in the UK, as it is in the USA.

  4. Corporate Governance of Sugar Mills in East Java: A Transaction Cost Economics Perspective

    Directory of Open Access Journals (Sweden)

    Ahmad Erani Yustika

    2007-01-01

    Full Text Available Despite Indonesia’s overall achievements during the past two decades%2C the economy is encountering a series of problems. One of the biggest challenges is the unsatisfactory performance of the state-owned enterprises (SOEs. Subsidisies and uncovered loans to the SOEs have drained the government’s fiscal resources%2C and the signing off of employees creates many social problems. Compared with the SOEs in other sectors%2C state-owned sugar mills face more serious crises which not only jeopardise the social fabric%2C but also endanger the production. Research results strengthen the statement that the basic problem in sugar mills is management inefficiency resulting in high transaction costs. This research compares the transaction costs between state-owned (Ngadiredjo and privately-owned (Kebon Agung sugar mills. The study shows that in Kebon Agung Sugar Mill transaction costs are higher than production costs%2C while in Ngadiredjo Sugar Mill the reverse is true. However%2C the high transaction costs in Kebon Agung Sugar Mill cannot be attributed directly to inefficient institutions%2C because Ngadiredjo Sugar Mill incurred high costs for plants%2C land preparation%2C and fertilizer%2C which decreased the proportion of transaction costs. If analyzed in detail%2C the following facts are revealed: (i market transaction costs in Kebon Agung Sugar Mill are higher than in Ngadiredjo Sugar Mill. This is because Kebon Agung Sugar Mill has established cooperation with sugarcane farmers in the form of extensions and transport subsidies; and (ii the political transaction costs proportion in Ngadiredjo Sugar Mill is higher than in Kebon Agung Sugar Mill because of the imposition of many ‘illegal’ fees. Abstract in Bahasa Indonesia : transaction cost economics%2C corporate governance%2C sugar mill%2C East Java.

  5. Comparing the Mass, Energy, and Cost Effects of Lightweighting in Conventional and Electric Passenger Vehicles

    Directory of Open Access Journals (Sweden)

    Johannes Hofer

    2014-09-01

    Full Text Available In this work the effect of weight reduction using advanced lightweight materials on the mass, energy use, and cost of conventional and battery electric passenger vehicles is compared. Analytic vehicle simulation is coupled with cost assessment to find the optimal degree of weight reduction minimizing manufacturing and total costs. The results show a strong secondary weight and cost saving potential for the battery electric vehicles, but a higher sensitivity of vehicle energy use to mass reduction for the conventional vehicle. Generally, light weighting has the potential to lower vehicle costs, however, the results are very sensitive to parameters affecting lifetime fuel costs for conventional and battery costs for electric vehicles. Based on current technology cost estimates it is shown that the optimal amount of primary mass reduction minimizing total costs is similar for conventional and electric vehicles and ranges from 22% to 39%, depending on vehicle range and overall use patterns. The difference between the optimal solutions minimizing manufacturing versus total costs is higher for conventional than battery electric vehicles.

  6. Costs of mixed low-level waste stabilization options

    International Nuclear Information System (INIS)

    Schwinkendorf, W.E.; Cooley, C.R.

    1998-01-01

    Selection of final waste forms to be used for disposal of DOE's mixed low-level waste (MLLW) depends on the waste form characteristics and total life cycle cost. In this paper the various cost factors associated with production and disposal of the final waste form are discussed and combined to develop life-cycle costs associated with several waste stabilization options. Cost factors used in this paper are based on a series of treatment system studies in which cost and mass balance analyses were performed for several mixed low-level waste treatment systems and various waste stabilization methods including vitrification, grout, phosphate bonded ceramic and polymer. Major cost elements include waste form production, final waste form volume, unit disposal cost, and system availability. Production of grout costs less than the production of a vitrified waste form if each treatment process has equal operating time (availability) each year; however, because of the lower volume of a high temperature slag, certification and handling costs and disposal costs of the final waste form are less. Both the total treatment cost and life cycle costs are higher for a system producing grout than for a system producing high temperature slag, assuming equal system availability. The treatment costs decrease with increasing availability regardless of the waste form produced. If the availability of a system producing grout is sufficiently greater than a system producing slag, then the cost of treatment for the grout system will be less than the cost for the slag system, and the life cycle cost (including disposal) may be less depending on the unit disposal cost. Treatment and disposal costs will determine the return on investment in improved system availability

  7. The cost of dementia in an unequal country: The case of Chile.

    Directory of Open Access Journals (Sweden)

    Daniel A Hojman

    Full Text Available We study the economic cost of dementia in Chile, and its variation according to socioeconomic status (SES. We use primary data from a survey of 330 informal primary caregivers who completed both a RUD-Lite and a socio-demographic questionnaire to evaluate the severity of dementia and caregiver's burden. The costs of dementia are broken into three components: direct medical costs (medical care, drugs, tests; direct social costs (social service, daycare; and indirect costs (mostly associated to informal care. The average monthly cost per patient is estimated at US$ 1,463. Direct medical costs account for 20 per cent, direct social costs for 5 per cent and indirect costs for 75 per cent of the total cost. The mean monthly cost is found to be inversely related to SES, a pattern largely driven by indirect costs. The monthly cost for high SES is US$ 1,083 and US$ 1,588 for low SES. A multivariate regression analysis suggests that severity of dementia and caregiver's burden account for between 49 and 70 per cent of the difference in the indirect cost across SES. However, between one-third and one-half of the variation across SES is not due to gradient in severity of dementia. Direct medical costs increase in higher SES, reflecting differences in purchasing power, while indirect costs are inversely related to SES and more than compensate differences in medical costs. Moreover, in lower SES groups, female caregivers, typically family members who are inactive in the labor market, mostly provide informal care. The average annual cost of dementia in Chile (US$ 17,559 is lower in comparison to high-income countries (US$ 39,595 and the proportion of cost related to informal cost is higher (74 per cent compared to 40 per cent. SES is a key determinant in the cost of dementia. In the absence of universal access to treatment, part of the social cost of dementia potentially preserves or increases income and gender inequality.

  8. Low-cost solar module manufacturing

    International Nuclear Information System (INIS)

    Little, Roger G.; Nowlan, Michael J.; Matthei, Keith W.; Darkazalli, Ghazi

    1997-01-01

    As the market for terrestrial photovoltaic modules expands beyond the 80 MW per year level, module manufacturers are adopting a number of cost-reduction strategies, including the use of higher throughput equipment, increased process automation, and the fabrication of larger area cells and modules. This paper reviews recent activities at Spire Corporation in the development of advanced module manufacturing and testing equipment

  9. Cost-effectiveness of Intensive Blood Pressure Management

    DEFF Research Database (Denmark)

    Richman, Ilana B; Fairley, Michael; Jørgensen, Mads Emil

    2016-01-01

    Importance: Among high-risk patients with hypertension, targeting a systolic blood pressure of 120 mm Hg reduces cardiovascular morbidity and mortality compared with a higher target. However, intensive blood pressure management incurs additional costs from treatment and from adverse events......-effectiveness of intensive blood pressure management among 68-year-old high-risk adults with hypertension but not diabetes. We used the Systolic Blood Pressure Intervention Trial (SPRINT) to estimate treatment effects and adverse event rates. We used Centers for Disease Control and Prevention Life Tables to project age...... and accrued $155 261 in lifetime costs, while intensive management yielded 10.5 QALYs and accrued $176 584 in costs. Intensive blood pressure management cost $23 777 per QALY gained. In a sensitivity analysis, serious adverse events would need to occur at 3 times the rate observed in SPRINT and be 3 times...

  10. High and rising health care costs.

    Science.gov (United States)

    Ginsburg, Paul B

    2008-10-01

    The U.S. is spending a growing share of the GDP on health care, outpacing other industrialized countries. This synthesis examines why costs are higher in the U.S. and what is driving their growth. Key findings include: health care inefficiency, medical technology and health status (particularly obesity) are the primary drivers of rising U.S. health care costs. Health payer systems that reward inefficiencies and preempt competition have impeded productivity gains in the health care sector. The best evidence indicates medical technology accounts for one-half to two-thirds of spending growth. While medical malpractice insurance and defensive medicine contribute to health costs, they are not large enough factors to significantly contribute to a rise in spending. Research is consistent that demographics will not be a significant factor in driving spending despite the aging baby boomers.

  11. Does Coordinated Postpartum Care Influence Costs?

    Directory of Open Access Journals (Sweden)

    Elisabeth Zemp

    2017-03-01

    Full Text Available Questions under study: To investigate changes to health insurance costs for post-discharge postpartum care after the introduction of a midwife-led coordinated care model. Methods: The study included mothers and their newborns insured by the Helsana health insurance group in Switzerland and who delivered between January 2012 and May 2013 in the canton of Basel Stadt (BS (intervention canton. We compared monthly post-discharge costs before the launch of a coordinated postpartum care model (control phase, n = 144 to those after its introduction (intervention phase, n = 92. Costs in the intervention canton were also compared to those in five control cantons without a coordinated postpartum care model (cross-sectional control group: n = 7, 767. Results: The average monthly post-discharge costs for mothers remained unchanged in the seven months following the introduction of a coordinated postpartum care model, despite a higher use of midwife services (increasing from 72% to 80%. Likewise, monthly costs did not differ between the intervention canton and five control cantons. In multivariate analyses, the ambulatory costs for mothers were not associated with the post-intervention phase. Cross-sectionally, however, they were positively associated with midwifery use. For children, costs in the post-intervention phase were lower in the first month after hospital discharge compared to the pre-intervention phase (difference of –114 CHF [95%CI –202 CHF to –27 CHF], yet no differences were seen in the cross-sectional comparison. Conclusions: The introduction of a coordinated postpartum care model was associated with decreased costs for neonates in the first month after hospital discharge. Despite increased midwifery use, costs for mothers remained unchanged.

  12. The costs of HIV/AIDS care at government hospitals in Zimbabwe

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Chapman, Glyn; Chitsike, Inam

    2000-01-01

    and care of HIV/AIDS patients in health facilities is necessary in order to have an idea of the likely costs of the increasing number of HIV/AIDS patients. Therefore, the present study estimated the costs per in-patient day as well as per in-patient stay for patients in government health facilities...... of the study indicate that hospital care for HIV/AIDS patients was considerably higher than for non-HIV/AIDS patients. In five of the seven hospitals visited, the average costs of an in-patient stay for an HIV/AIDS patient were found to be as much as twice as high as a non-HIV/AIDS patient. This difference...... could be attributed to higher direct costs per in-patient day (medication, laboratory tests and X-rays) as well as longer average lengths of stay in hospital for HIV/AIDS patients compared with non-infected patients. Therefore, the impact on hospital services of increasing number of HIV/AIDS patients...

  13. Costs and cost-effectiveness of periviable care.

    Science.gov (United States)

    Caughey, Aaron B; Burchfield, David J

    2014-02-01

    With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. An Insight Into the Two Costing Technique: Absorption Costing and Marginal Costing

    Directory of Open Access Journals (Sweden)

    Mariam Nawaz

    2013-02-01

    Full Text Available This paper will investigate the controversy that is innate between the two costing techniques; Absorption Costing and Marginal Costing and would throw light on which costing technique better serves its purpose in helping management for decision making process and if Marginal Costing technique is concluded as better technique then why it should not be used for external reporting purpose. This paper will only crystallize and highlight the issues descriptively and will not resolve the issues that are inherent between the two costing techniques. The unique thing about this paper is that it is in favor of treating fixed cost as product cost that is it is supporting the advocates of Absorption Costing Technique but it is against to consider profit as a function of production rather it believes that profit should only be considered as function of sales for stock valuation and to help management in decision making process that is, regarding this point it is supporting advocates of Marginal Costing.

  15. The cost-effectiveness, health benefits, and financial costs of new antiviral treatments for hepatitis C virus.

    Science.gov (United States)

    Rein, David B; Wittenborn, John S; Smith, Bryce D; Liffmann, Danielle K; Ward, John W

    2015-07-15

    New hepatitis C virus (HCV) treatments deliver higher cure rates with fewer contraindications, increasing demand for treatment and healthcare costs. The cost-effectiveness of new treatments is unknown. We conducted a microsimulation of guideline testing followed by alternative treatment regimens for HCV among the US population aged 20 and older to estimate cases identified, treated, sustained viral response, deaths, medical costs, quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER) of different treatment options expressed as discounted lifetime costs and benefits from the healthcare perspective. Compared to treatment with pegylated interferon and ribavirin (PR), and a protease inhibitor for HCV genotype (G) 1 and PR alone for G2/3, treatment with PR and Sofosbuvir (PRS) for G1/4 and treatment with Sofosbuvir and ribavirin (SR) for G2/3 increased QALYs by 555 226, reduced deaths by 80 682, and increased costs by $26.2 billion at an ICER of $47 304 per QALY gained. As compared to PRS/SR, treating with an all oral regimen of Sofosbuvir and Simeprevir (SS) for G1/4 and SR for G2/3, increased QALYs by 1 110 451 and reduced deaths by an additional 164 540 at an incremental cost of $80.1 billion and an ICER of $72 169. In sensitivity analysis, where treatment with SS effectiveness was set to the list price of Viekira Pak and then Harvoni, treatment cost $24 921 and $25 405 per QALY gained as compared to PRS/SR. New treatments are cost-effectiveness per person treated, but pent-up demand for treatment may create challenges for financing. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Flat plate vs. concentrator solar photovoltaic cells - A manufacturing cost analysis

    Science.gov (United States)

    Granon, L. A.; Coleman, M. G.

    1980-01-01

    The choice of which photovoltaic system (flat plate or concentrator) to use for utilizing solar cells to generate electricity depends mainly on the cost. A detailed, comparative manufacturing cost analysis of the two types of systems is presented. Several common assumptions, i.e., cell thickness, interest rate, power rate, factory production life, polysilicon cost, and direct labor rate are utilized in this analysis. Process sequences, cost variables, and sensitivity analyses have been studied, and results of the latter show that the most important parameters which determine manufacturing costs are concentration ratio, manufacturing volume, and cell efficiency. The total cost per watt of the flat plate solar cell is $1.45, and that of the concentrator solar cell is $1.85, the higher cost being due to the increased process complexity and material costs.

  17. The Hospitalization Costs of Diabetes and Hypertension Complications in Zimbabwe: Estimations and Correlations

    Directory of Open Access Journals (Sweden)

    Mutsa P. Mutowo

    2016-01-01

    Full Text Available Objective. Treating complications associated with diabetes and hypertension imposes significant costs on health care systems. This study estimated the hospitalization costs for inpatients in a public hospital in Zimbabwe. Methods. The study was retrospective and utilized secondary data from medical records. Total hospitalization costs were estimated using generalized linear models. Results. The median cost and interquartile range (IQR for patients with diabetes, $994 (385–1553 mean $1319 (95% CI: 981–1657, was higher than patients with hypertension, $759 (494–1147 mean $914 (95% CI: 825–1003. Female patients aged below 65 years with diabetes had the highest estimated mean costs ($1467 (95% CI: 1177–1828. Wound care had the highest estimated mean cost of all procedures, $2884 (95% CI: 2004–4149 for patients with diabetes and $2239 (95% CI: 1589–3156 for patients with hypertension. Age below 65 years, medical procedures (amputation, wound care, dialysis, and physiotherapy, the presence of two or more comorbidities, and being prescribed two or more drugs were associated with significantly higher hospitalization costs. Conclusion. Our estimated costs could be used to evaluate and improve current inpatient treatment and management of patients with diabetes and hypertension and determine the most cost-effective interventions to prevent complications and comorbidities.

  18. Nuclear power costs in the build, operate, transfer approach

    International Nuclear Information System (INIS)

    Aybers, M.N.; Sahin, B.

    1990-01-01

    The costs of nuclear power are discussed with special reference to the economic problems faced by developing countries, and the relative merit of a new accounting approach, viz., the build, operate, transfer contract model, which was proposed in Turkey for the Akkuyu nuclear power project, is illustrated. In this context, the general methodology of calculating nuclear power costs is summarized and a capital cost analysis for a 986 MW pressurized water reactor plant is given in terms of constant monetary units for the above contract model and the turnkey contract model. Adjustment of the costs taking into account regional conditions such as inflation and higher interest rates is also indicated. (orig.) [de

  19. Land Application of Biosolids in the USA: A Review

    Directory of Open Access Journals (Sweden)

    Qin Lu

    2012-01-01

    Full Text Available Land application of biosolids has proven a cost-effective method of waste disposal by beneficially recycling organic matter and nutrients and improving soil quality; however, it may also pose potential threat to the environment and human health. The purpose of this paper is to provide information on recent research progresses and regulation efforts regarding land application of biosolids, including forms and types and nutrient values of biosolids, environmental and health concerns, and related best management practices (BMPs of biosolids application, with emphasis on its land application in agriculture. More research and regulations are expected to minimize potential risks of biosolids land application, especially its long-term impacts.

  20. Production costs of liquid fuels from biomass

    International Nuclear Information System (INIS)

    Bridgwater, A.V.; Double, J.M.

    1994-01-01

    This project was undertaken to provide a consistent and thorough review of the full range of processes for producing liquid fuels from biomass to compare both alternative technologies and processes within those technologies in order to identify the most promising opportunities that deserve closer attention. Thermochemical conversion includes both indirect liquefaction through gasification, and direct liquefaction through pyrolysis and liquefaction in pressurized solvents. Biochemical conversion is based on a different set of feedstocks. Both acid and enzyme hydrolysis are included followed by fermentation. The liquid products considered include gasoline and diesel hydrocarbons and conventional alcohol fuels of methanol and ethanol. Results are given both as absolute fuel costs and as a comparison of estimated cost to market price. In terms of absolute fuel costs, thermochemical conversion offers the lowest cost products, with the least complex processes generally having an advantage. Biochemical routes are the least attractive. The most attractive processes from comparing production costs to product values are generally the alcohol fuels which enjoy a higher market value. (author)

  1. How much does a tokamak reactor cost?

    Science.gov (United States)

    Freidberg, J.; Cerfon, A.; Ballinger, S.; Barber, J.; Dogra, A.; McCarthy, W.; Milanese, L.; Mouratidis, T.; Redman, W.; Sandberg, A.; Segal, D.; Simpson, R.; Sorensen, C.; Zhou, M.

    2017-10-01

    The cost of a fusion reactor is of critical importance to its ultimate acceptability as a commercial source of electricity. While there are general rules of thumb for scaling both overnight cost and levelized cost of electricity the corresponding relations are not very accurate or universally agreed upon. We have carried out a series of scaling studies of tokamak reactor costs based on reasonably sophisticated plasma and engineering models. The analysis is largely analytic, requiring only a simple numerical code, thus allowing a very large number of designs. Importantly, the studies are aimed at plasma physicists rather than fusion engineers. The goals are to assess the pros and cons of steady state burning plasma experiments and reactors. One specific set of results discusses the benefits of higher magnetic fields, now possible because of the recent development of high T rare earth superconductors (REBCO); with this goal in mind, we calculate quantitative expressions, including both scaling and multiplicative constants, for cost and major radius as a function of central magnetic field.

  2. COST OF PRIMARY HEALTH CARE IN PAKISTAN.

    Science.gov (United States)

    Malik, Muhammad Ashar; Gul, Wahid; Iqbal, Saleem Perwaiz; Abrejo, Farina

    2015-01-01

    Detailed cost analysis is an important tool for review of health policy and reforms. We provide an estimate of cost of service and its detailed breakup on out-door patient visits (OPV) to basic health units (BHU) in Pakistan. Six BHUs were randomly selected from each of the five districts in Khyber Pukhtonkhawa (KPK) and two agencies in Federally Administered Tribal Areas (FATA) of Pakistan for this study. Actual expenditure data and utilization data in the year 2005-06 of 42 BHUs was collected from selected district health offices in KPK and FATA. Costs were estimated for outpatient visits to BHUs. Perspective on cost estimates was district-based health planning and management of BHUs. Average recurring cost was PKR.245 (USD 4.1) per OPV to BHU. Staff salaries constituted 90% of recurrent cost. On the average there were 16 OPV per day to the BHUs. CONCLUDION: Recurrent cost per OPV has doubled from the previous estimates of cost of OPV in Baluchistan. The estimated recurrent cost was six times higher than average consultation charges with the private general practitioner (GP) in the country (i.e., PKR 50/ GP consultation). Performance of majority of the BHUs was much lower than the performance target (50 patients per day) set in the sixth five-year plan of the government of Pakistan. The Government of Pakistan may use these analyses to revisit the performance target, staffinL and location of BHUs.

  3. Cost-effectiveness of hepatitis B vaccination of prison inmates.

    Science.gov (United States)

    Pisu, Maria; Meltzer, Martin Isaac; Lyerla, Rob

    2002-12-13

    The purpose of this paper is to determine the cost-effectiveness of vaccinating inmates against hepatitis B. From the prison perspective, vaccinating inmates at intake is not cost-saving. It could be economically beneficial when the cost of a vaccine dose is US dollars 30 per dose, or there is no prevalence of infection upon intake, or the costs of treating acute or chronic disease are about 70% higher than baseline costs, or the incidence of infection during and after custody were >1.6 and 50%, respectively. The health care system realizes net savings even when there is no incidence in prison, or there is no cost of chronic liver disease, or when only one dose of vaccine is administered. Thus, while prisons might not have economic incentives to implement hepatitis B vaccination programs, the health care system would benefit from allocating resources to them.

  4. The Societal Benefits and Costs of School Dropout Recovery

    Directory of Open Access Journals (Sweden)

    James S. Catterall

    2011-01-01

    Full Text Available This article reports an analysis of the societal benefits and costs of recovering school dropouts. Successful recovery is defined by subsequent graduation from high school. The analysis is based on established estimates of the societal costs of dropping out including reduced government tax collections and higher social costs of welfare, healthcare, and crime. These potential costs are cast as benefits when a dropout is recovered. A large dropout recovery program provides the setting for the analysis. Rigorous attention is given to accurate estimation of the number of students who would not have graduated without the program in the year assessed and to the induced public costs of their continued education. Estimated benefits are weighed against the total annual public costs of the program, which operates in 65 school centers and commands an annual budget of about $70 million. The estimated benefit-cost ratio for this program is 3 to 1, a figure comparable to benefit-cost ratio estimates reported in studies of dropout prevention. The sensitivity of this conclusion to specific assumptions within the analysis is discussed.

  5. The Economics of NASA Mission Cost Reserves

    Science.gov (United States)

    Whitley, Sally; Shinn, Stephen

    2012-01-01

    Increases in NASA mission costs are well-noted but not well-understood, and there is little evidence that they are decreasing in frequency or amount over time. The need to control spending has led to analysis of the causes and magnitude of historical mission overruns, and many program control efforts are being implemented to attempt to prevent or mitigate the problem (NPR 7120). However, cost overruns have not abated, and while some direct causes of increased spending may be obvious (requirements creep, launch delays, directed changes, etc.), the underlying impetus to spend past the original budget may be more subtle. Gaining better insight into the causes of cost overruns will help NASA and its contracting organizations to avoid .them. This paper hypothesizes that one cause of NASA mission cost overruns is that the availability of reserves gives project team members an incentive to make decisions and behave in ways that increase costs. We theorize that the presence of reserves is a contributing factor to cost overruns because it causes organizations to use their funds less efficiently or to control spending less effectively. We draw a comparison to the insurance industry concept of moral hazard, the phenomenon that the presence of insurance causes insureds to have more frequent and higher insurance losses, and we attempt to apply actuarial techniques to quantifY the increase in the expected cost of a mission due to the availability of reserves. We create a theoretical model of reserve spending motivation by defining a variable ReserveSpending as a function of total reserves. This function has a positive slope; for every dollar of reserves available, there is a positive probability of spending it. Finally, the function should be concave down; the probability of spending each incremental dollar of reserves decreases progressively. We test the model against available NASA CADRe data by examining missions with reserve dollars initially available and testing whether

  6. "Factors associated with non-small cell lung cancer treatment costs in a Brazilian public hospital".

    Science.gov (United States)

    de Barros Reis, Carla; Knust, Renata Erthal; de Aguiar Pereira, Claudia Cristina; Portela, Margareth Crisóstomo

    2018-02-17

    The present study estimated the cost of advanced non-small cell lung cancer care for a cohort of 251 patients enrolled in a Brazilian public hospital and identified factors associated with the cost of treating the disease, considering sociodemographic, clinical and behavioral characteristics of patients, service utilization patterns and survival time. Estimates were obtained from the survey of direct medical cost per patient from the hospital's perspective. Data was collected from medical records and available hospital information systems. The ordinary least squares (OLS) method with logarithmic transformation of the dependent variable for the analysis of cost predictors was used to take into account the positive skewness of the costs distribution. The average cost of NSCLC was US$ 5647 for patients, with 71% of costs being associated to outpatient care. The main components of cost were daily hospital bed stay (22.6%), radiotherapy (15.5%) and chemotherapy (38.5%). The OLS model reported that, with 5% significance level, patients with higher levels of education, with better physical performance and less advanced disease have higher treatment costs. After controlling for the patient's survival time, only education and service utilization patterns were statistically significant. Individuals who were hospitalized or made use of radiotherapy or chemotherapy had higher costs. The use of these outpatient and hospital services explained most of the treatment cost variation, with a significant increase of the adjusted R 2 of 0.111 to 0.449 after incorporation of these variables in the model. The explanatory power of the complete model reached 62%. Inequities in disease treatment costs were observed, pointing to the need for strategies that reduce lower socioeconomic status and population's hurdles to accessing cancer care services.

  7. Cost-effectiveness in fall prevention for older women.

    Science.gov (United States)

    Hektoen, Liv F; Aas, Eline; Lurås, Hilde

    2009-08-01

    The aim of this study was to estimate the cost-effectiveness of implementing an exercise-based fall prevention programme for home-dwelling women in the > or = 80-year age group in Norway. The impact of the home-based individual exercise programme on the number of falls is based on a New Zealand study. On the basis of the cost estimates and the estimated reduction in the number of falls obtained with the chosen programme, we calculated the incremental costs and the incremental effect of the exercise programme as compared with no prevention. The calculation of the average healthcare cost of falling was based on assumptions regarding the distribution of fall injuries reported in the literature, four constructed representative case histories, assumptions regarding healthcare provision associated with the treatment of the specified cases, and estimated unit costs from Norwegian cost data. We calculated the average healthcare costs per fall for the first year. We found that the reduction in healthcare costs per individual for treating fall-related injuries was 1.85 times higher than the cost of implementing a fall prevention programme. The reduction in healthcare costs more than offset the cost of the prevention programme for women aged > or = 80 years living at home, which indicates that health authorities should increase their focus on prevention. The main intention of this article is to stipulate costs connected to falls among the elderly in a transparent way and visualize the whole cost picture. Cost-effectiveness analysis is a health policy tool that makes politicians and other makers of health policy conscious of this complexity.

  8. Quality-Adjusted Cost Functions for Child-Care Centers.

    OpenAIRE

    Mocan, H Naci

    1995-01-01

    Using a newly compiled data set, this paper estimates multi- product translog cost functions for 399 child care centers from California, Colorado, Connecticut, and North Carolina. Quality of child care is controlled by a quality index, which has been shown to be positively related to child outcomes by previous research. Nonprofit centers that receive public money, either from the state or federal government, (which is tied to higher standards), have total variable costs that are 18 percent hi...

  9. Patterns of Daily Costs Differ for Medical and Surgical Intensive Care Unit Patients.

    Science.gov (United States)

    Gershengorn, Hayley B; Garland, Allan; Gong, Michelle N

    2015-12-01

    Published studies suggest hospital costs on Day 1 in the intensive care unit (ICU) far exceed those of subsequent days, when costs are relatively stable. Yet, no study stratified patients by ICU type. To determine whether daily cost patterns differ by ICU type. We performed a retrospective study of adults admitted to five ICUs (two surgical: quaternary surgical ICU [SICU quat] and quaternary cardiac surgical ICU [CSICU quat]; two medical: tertiary medical ICU [MICU tertiary] and quaternary medical ICU [MICU quat]; one general: community medical surgical ICU [MSICU comm]) at Montefiore Medical Center in the Bronx, New York during 2013. After excluding costs clearly accrued outside the ICU, daily hospital costs were merged with clinical data. Patterns of daily unadjusted costs were evaluated in each ICU using median regression. Generalized estimating equations with first-order autocorrelation were used to identify factors independently associated with daily costs. Unadjusted daily costs were higher on Day 1 than on subsequent days only for surgical ICUs-SICU quat (median [interquartile range], $2,636 [$1,834-$4,282] on Day 1 vs. $1,840 [$1,501-$2,332] on Day 2; P cost from Days 1 to 2. After multivariate adjustment, there remained a significant decrease in cost from ICU Day 1 to 2 in surgical units with statistically similar Day 1 and 2 costs for other ICUs. Higher Day 1 costs are not seen in patients admitted to medical/nonsurgical ICUs.

  10. New York State interim waste management cost evaluation

    International Nuclear Information System (INIS)

    Ma, M.S.; Watts, R.J.; Jorgensen, J.R.; Rochester Gas and Electric Corp., NY)

    1985-01-01

    The purpose of this study is to investigate and quantify the comparative costs associated with including or excluding Class A utility wastes at a centralized interim waste management facility in New York State. The objective of the study is to assess the unit costs and total statewide costs associated with two distinct scenarios: (1) the case where non-utility Class A LLRW is received, incinerated and stored at the centralized interim facility, and utility Class A wastes are held without incineration at respective nuclear power plant interim onsite facilities without incineration; and (2) the alternative case where both utility and non-utility Class A wastes are accepted, incinerated and stored at the centralized facility. Unit costs to waste generators are estimated for each of the two cases described. This is followed by an estimation of the statewide cost impact to the public. The cost impact represents the cost differential resulting from the exclusion of utility Class A waste from the centralized NYS interim waste management facility. The principal factors comprising the cost differential include (1) higher unit disposal fees charged to non-utility waste generators, which are passed along in the costs of products and services; and (2) costs to utilities due to construction of additional onsite storage capacity, which in turn are charged to electric rate payers

  11. Tax compliance costs: A review of cost burdens and cost structures

    OpenAIRE

    Eichfelder, Sebastian; Vaillancourt, François

    2014-01-01

    Our paper provides a comprehensive report of empirical research on tax compliance costs. Compared to previous reviews, our focus is on average costs for sub-groups (individual taxpayers, small business-es, large businesses) and the composition of the cost burden with regards to different cost components(in-house time effort, external adviser costs, other monetary expenses), different taxes (e.g. income tax, value added tax) and different activities like tax accounting and tax planning. In add...

  12. Relationship between functional disability and costs one and two years post stroke

    Science.gov (United States)

    Lekander, Ingrid; Willers, Carl; von Euler, Mia; Lilja, Mikael; Sunnerhagen, Katharina S.; Pessah-Rasmussen, Hélène; Borgström, Fredrik

    2017-01-01

    Background and purpose Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS) or hemorrhagic stroke (ICH)). Method Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services) and indirect (productivity losses) costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS). Results The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000–480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000–1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability. Conclusion Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH) was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke. PMID:28384164

  13. Relationship between functional disability and costs one and two years post stroke.

    Directory of Open Access Journals (Sweden)

    Ingrid Lekander

    Full Text Available Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS or hemorrhagic stroke (ICH.Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services and indirect (productivity losses costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS.The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000-480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000-1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability.Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke.

  14. A new R-SWAT Decision Making Framework for the Efficient Allocation of Best Management Practices

    OpenAIRE

    UDIAS MOINELO ANGEL; MALAGO ANNA; REYNAUD ARNAUD; PASTORI MARCO; VIGIAK OLGA; BOURAOUI Faycal

    2015-01-01

    The work presents and illustrates the application of R-SWAT-DM, a new R framework designed for Decision Making (DM), related to the implementation of Best Management Practices (BMPs), for restoring and protecting the good ecological status of freshwater bodies. R-SWAT-DM combines the use of the SWAT watershed model, the spatial representation of BMPs and an economic component. The SWAT model served as the nonpoint source pollution estimator for current conditions (base line) as well as for sc...

  15. Moderation of the Relation of County-Level Cost of Living to Nutrition by the Supplemental Nutrition Assistance Program.

    Science.gov (United States)

    Basu, Sanjay; Wimer, Christopher; Seligman, Hilary

    2016-11-01

    To examine the association of county-level cost of living with nutrition among low-income Americans. We used the National Household Food Acquisition and Purchase Survey (2012-2013; n = 14 313; including 5414 persons in households participating in the Supplemental Nutrition Assistance Program [SNAP]) to examine associations between county-level cost-of-living metrics and both food acquisitions and the Healthy Eating Index, with control for individual-, household-, and county-level covariates and accounting for unmeasured confounders influencing both area of living and food acquisition. Living in a higher-cost county-particularly one with high rent costs-was associated with significantly lower volume of acquired vegetables, fruits, and whole grains; greater volume of acquired refined grains, fats and oils, and added sugars; and an 11% lower Healthy Eating Index score. Participation in SNAP was associated with nutritional improvements among persons living in higher-cost counties. Living in a higher-cost county (particularly with high rent costs) is associated with poorer nutrition among low-income Americans, and SNAP may mitigate the negative nutritional impact of high cost of living.

  16. Respiratory viral infections in infancy and school age respiratory outcomes and healthcare costs.

    Science.gov (United States)

    MacBean, Victoria; Drysdale, Simon B; Yarzi, Muska N; Peacock, Janet L; Rafferty, Gerrard F; Greenough, Anne

    2018-03-01

    To determine the impact of viral lower respiratory tract infections (LRTIs) in infancy including rhinovirus (RV) and infancy respiratory syncytial virus (RSV), on school age pulmonary function and healthcare utilization in prematurely born children. School age respiratory outcomes would be worse and healthcare utilization greater in children who had viral LRTIs in infancy. Prospective study. A cohort of prematurely born children who had symptomatic LRTIs during infancy documented, was recalled. Pulmonary function was assessed at 5 to 7 years of age and health related costs of care from aged one to follow-up determined. Fifty-one children, median gestational age 33 +6 weeks, were assessed at a median (IQR) age 7.03 (6.37-7.26) years. Twenty-one children had no LRTI, 14 RV LRTI, 10 RSV LRTI, and 6 another viral LRTI (other LRTI). Compared to the no LRTI group, the RV group had a lower FEV 1 (P = 0.033) and the other LRTI group a lower FVC (P = 0.006). Non-respiratory medication costs were higher in the RV (P = 0.018) and RSV (P = 0.013) groups. Overall respiratory healthcare costs in the RV (£153/year) and RSV (£27/year) groups did not differ significantly from the no LRTI group (£56/year); the other LRTI group (£431/year) had higher respiratory healthcare costs (P = 0.042). In moderately prematurely born children, RV and RSV LRTIs in infancy were not associated with higher respiratory healthcare costs after infancy. Children who experienced LRTIs caused by other respiratory viruses (including RV) had higher respiratory healthcare costs and greater pulmonary function impairment. © 2018 Wiley Periodicals, Inc.

  17. Leveraging Service Blueprinting to Rethink Higher Education: When Students Become "Valued Customers," Everybody Wins

    Science.gov (United States)

    Ostrom, Amy L.; Bitner, Mary Jo; Burkhard, Kevin A.

    2011-01-01

    There is much discussion today about the need to transform higher education. Experts and researchers list numerous challenges: low student retention and graduation rates, the increasing cost of higher education, and concerns that graduates don't possess the skills required to compete successfully in today's interconnected, global marketplace.…

  18. Energy use, cost and CO2 emissions of electric cars

    International Nuclear Information System (INIS)

    van Vliet, Oscar; Brouwer, Anne Sjoerd; Kuramochi, Takeshi; van den Broek, Machteld; Faaij, Andre

    2011-01-01

    We examine efficiency, costs and greenhouse gas emissions of current and future electric cars (EV), including the impact from charging EV on electricity demand and infrastructure for generation and distribution. Uncoordinated charging would increase national peak load by 7% at 30% penetration rate of EV and household peak load by 54%, which may exceed the capacity of existing electricity distribution infrastructure. At 30% penetration of EV, off-peak charging would result in a 20% higher, more stable base load and no additional peak load at the national level and up to 7% higher peak load at the household level. Therefore, if off-peak charging is successfully introduced, electric driving need not require additional generation capacity, even in case of 100% switch to electric vehicles. GHG emissions from electric driving depend most on the fuel type (coal or natural gas) used in the generation of electricity for charging, and range between 0 g km -1 (using renewables) and 155 g km -1 (using electricity from an old coal-based plant). Based on the generation capacity projected for the Netherlands in 2015, electricity for EV charging would largely be generated using natural gas, emitting 35-77 g CO 2 eq km -1 . We find that total cost of ownership (TCO) of current EV are uncompetitive with regular cars and series hybrid cars by more than 800 EUR year -1 . TCO of future wheel motor PHEV may become competitive when batteries cost 400 EUR kWh -1 , even without tax incentives, as long as one battery pack can last for the lifespan of the vehicle. However, TCO of future battery powered cars is at least 25% higher than of series hybrid or regular cars. This cost gap remains unless cost of batteries drops to 150 EUR kWh -1 in the future. Variations in driving cost from charging patterns have negligible influence on TCO. GHG abatement costs using plug-in hybrid cars are currently 400-1400 EUR tonne -1 CO 2eq and may come down to -100 to 300 EUR tonne -1 . Abatement cost using

  19. Implementation of Cost Sharing in the Ethiopian Higher Education Landscape: Critical Assessment and the Way Forward

    Science.gov (United States)

    Yizengaw, Teshome

    2007-01-01

    Higher education participation in Ethiopia is very low (about 1.5 per cent) and is the major source of the critical shortage of educated and skilled human resource. The higher education system in Ethiopia is moving away from exclusive and dismally low enrolments towards increasing participation. To expand access, to redress inequitable subsidies…

  20. Role of energy cost in the yield of cold ternary fission of Cf

    Indian Academy of Sciences (India)

    Abstract. The energy costs in the cold ternary fission of 252Cf for various light charged particle emission are calculated by including Wong's correction for Coulomb potential. Energy cost is found to be higher in cold fission than in normal fission. It is found that energy cost always increases with decrease in experimental yield ...